Healthcare Provider Details

I. General information

NPI: 1225824808
Provider Name (Legal Business Name): ADAM ISIDRO MIRANDA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2025
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 CAMINO DEL REMEDIO
SANTA BARBARA CA
93110-1332
US

IV. Provider business mailing address

305 CAMINO DEL REMEDIO
SANTA BARBARA CA
93110-1332
US

V. Phone/Fax

Practice location:
  • Phone: 805-465-8199
  • Fax: 805-681-9144
Mailing address:
  • Phone: 805-465-8199
  • Fax: 805-681-9144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: