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General NPI Number Information
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NPI Number | 1962724039
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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 | 02/17/2010
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Last Update Date | 02/26/2020
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Provider Practice Location Address
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Address Line | 1400 S HARBOR BLVD SUITE A
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City | LA HABRA
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State | CA
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Zip | 90631-7577
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Country | US
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Telephone | 714-879-3400
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Fax | 714-441-1998
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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 | 25691
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License Number State | CA
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