MEDICARE: MIKIO A NIHIRA MD

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	207V00000X	Obstetrics & Gynecology Physician	24796	OK
2	207VF0040X	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	24796	OK

General Provider Information

NPI Number	:	1326016114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIKIO A NIHIRA MD

Provider Business Mailing Address
First Line	:	21160 VIA TEODOCIO
Second Line	:
City	:	YORBA LINDA
State	:	CA
Zip	:	92887-1819
Country	:	US
Telephone Number	:	405-274-3111
Fax Number	:

Provider Business Practice Location Address
First Line	:	19330 JESSE LN STE 100
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92508-5077
Country	:	US
Telephone Number	:	844-827-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	04/10/2020

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