Healthcare Provider Details

I. General information

NPI: 1023351004
Provider Name (Legal Business Name): BRIGHT HEALTH PHYSICIANS OF PIH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2013
Last Update Date: 05/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12215 TELEGRAPH RD
SANTA FE SPRINGS CA
90670-3344
US

IV. Provider business mailing address

PO BOX 1277
WHITTIER CA
90609-1277
US

V. Phone/Fax

Practice location:
  • Phone: 562-789-5450
  • Fax: 562-789-5469
Mailing address:
  • Phone: 562-789-5401
  • Fax: 562-789-5912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: KEITH S MIYAMOTO
Title or Position: PRESIDENT
Credential: MD
Phone: 562-789-5401