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General NPI Number Information
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NPI Number | 1366909483
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Entity Type | Individual
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Provider Name | SIMONE MILES
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Gender | Female
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Dates
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Enumeration Date | 02/25/2019
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Last Update Date | 02/25/2019
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Provider Practice Location Address
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Address Line | 304 VALENCIA ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94103-3505
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Country | US
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Telephone | 415-861-4526
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Fax |
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Provider Business Mailing Address
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Address Line | 916 NEWHALL ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94124-2143
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Country | US
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Telephone | 415-336-4905
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Fax |
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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 | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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License Number | 20049871
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License Number State | CA
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