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General NPI Number Information
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NPI Number | 1104149970
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Entity Type | Organization
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Legal Business Name | PIH HEALTH PHYSICIANS
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 02/04/2020
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Provider Practice Location Address
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Address Line | 12215 TELEGRAPH RD SUITE 112
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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 | 562-864-2518
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Fax | 562-777-7812
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Provider Business Mailing Address
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Address Line | P O 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 | DR. 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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0774
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 0774
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License Number State | CA
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