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General NPI Number Information
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NPI Number | 1063919249
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Entity Type | Individual
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Provider Name | MIRIAM A VELAZQUEZ DO
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Gender | Female
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Dates
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Enumeration Date | 04/12/2018
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 20001 S RANCHO WAY
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City | RANCHO DOMINGUEZ
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State | CA
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Zip | 90220-6318
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Country | US
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Telephone | 310-225-3221
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Fax | 310-698-7040
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Provider Business Mailing Address
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Address Line | 20001 S RANCHO WAY
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City | RANCHO DOMINGUEZ
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State | CA
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Zip | 90220-6318
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Country | US
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Telephone | 310-225-3221
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Fax | 310-698-7040
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 20A19380
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License Number State | CA
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