MEDICARE: MR. RUBEN MIRANDA

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	104100000X	Social Worker	116373	CA

General Provider Information

NPI Number	:	1548934144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RUBEN MIRANDA

Provider Business Mailing Address
First Line	:	13631 JEREMY CT
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91739-2031
Country	:	US
Telephone Number	:	909-803-0601
Fax Number	:

Provider Business Practice Location Address
First Line	:	13631 JEREMY CT
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91739-2031
Country	:	US
Telephone Number	:	909-803-0601
Fax Number	:

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

Provider Enumeration Date	:	08/06/2021
Last Update Date	:	11/25/2025

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Directions to “ MR. RUBEN MIRANDA ” Practice Location

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