Healthcare Provider Details

I. General information

NPI: 1720232465
Provider Name (Legal Business Name): PIH HEALTH PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2008
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12522 LAMBERT RD SUITE D
WHITTIER CA
90606-2758
US

IV. Provider business mailing address

P O BOX 1277
WHITTIER CA
90609-1277
US

V. Phone/Fax

Practice location:
  • Phone: 562-789-5420
  • Fax: 562-967-2929
Mailing address:
  • Phone: 562-906-6470
  • Fax: 562-946-9465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KEITH S. MIYAMOTO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 562-789-5401