MEDICARE: MIDEO HEALTH OF CALIFORNIA INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1154151157
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDEO HEALTH OF CALIFORNIA INC

Provider Business Mailing Address
First Line	:	2409 STATE ST
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16503-1856
Country	:	US
Telephone Number	:	814-434-4824
Fax Number	:	330-451-4172

Provider Business Practice Location Address
First Line	:	1267 SOUTH LOS ROBLES AVE
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-4316
Country	:	US
Telephone Number	:	844-643-3648
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. FERDINANDO L MIRARCHI
Credential	:	DO
Telephone Number	:	844-643-3648

Provider Enumeration Date	:	08/05/2024
Last Update Date	:	02/16/2026

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