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General NPI Number Information
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NPI Number | 1710946868
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Entity Type | Individual
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Provider Name | EDWARD P. MIRANDA M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/18/2006
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Last Update Date | 09/28/2017
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Provider Practice Location Address
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Address Line | 77 VAN NESS AVENUE SUITE 302
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City | SAN FRANCISCO
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State | CA
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Zip | 94102
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Country | US
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Telephone | 415-379-9015
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Fax | 415-379-9045
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Provider Business Mailing Address
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Address Line | 77 VAN NESS AVENUE SUITE 302
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City | SAN FRANCISCO
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State | CA
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Zip | 94102
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Country | US
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Telephone | 415-379-9015
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Fax | 415-379-9045
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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 | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | A82349
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | 232599
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 232599
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | A82349
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A82349
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 232599
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License Number State | NY
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Taxonomy #7
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Taxonomy Code | 2082S0099X
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Taxonomy Name | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
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License Number | A82349
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License Number State | CA
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Taxonomy #8
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Taxonomy Code | 2082S0099X
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Taxonomy Name | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
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License Number | 232599
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License Number State | NY
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Taxonomy #9
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number | A82349
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License Number State | CA
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Taxonomy #10
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number | 232599
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License Number State | NY
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Taxonomy #11
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A82349
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License Number State | CA
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Taxonomy #12
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 232599
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License Number State | NY
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Taxonomy #13
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 232599
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License Number State | NY
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Taxonomy #14
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Taxonomy Code | 209800000X
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Taxonomy Name | Legal Medicine (M.D./D.O.) Physician
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License Number | A82349
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License Number State | CA
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Taxonomy #15
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | A82349
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License Number State | CA
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