Healthcare Provider Details

I. General information

NPI: 1376793695
Provider Name (Legal Business Name): PIH HEALTH PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12291 WASHINGTON BLVD SUITES 102 -201 -205
WHITTIER CA
90606-2500
US

IV. Provider business mailing address

PO BOX 1277
WHITTIER CA
90609-1277
US

V. Phone/Fax

Practice location:
  • Phone: 562-698-0306
  • Fax: 562-789-5459
Mailing address:
  • Phone: 562-906-6470
  • Fax: 562-946-9465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

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