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General NPI Number Information
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NPI Number | 1023351004
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Entity Type | Organization
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Legal Business Name | BRIGHT HEALTH PHYSICIANS OF PIH
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Dates
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Enumeration Date | 03/28/2013
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 12215 TELEGRAPH RD
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City | SANTA FE SPRINGS
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State | CA
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Zip | 90670-3344
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Country | US
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Telephone | 562-789-5450
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Fax | 562-789-5469
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Provider Business Mailing Address
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Address Line | PO BOX 1277
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City | WHITTIER
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State | CA
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Zip | 90609-1277
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Country | US
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Telephone | 562-789-5401
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Fax | 562-789-5912
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEITH S MIYAMOTO
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Credential | MD
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Telephone | 562-789-5401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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