Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 232599 | NY |
N | 208600000X | Surgeon | 232599 | NY |
Y | 208200000X | Surgeon | A82349 | CA |
Y | 208600000X | Surgeon | A82349 | CA |
N | 2082S0105X | Plastic Hand Surgeon | 232599 | NY |
N | 2082S0105X | Plastic Hand Surgeon | A82349 | CA |
N | 208200000X | Surgeon | 232599 | NY |
N | 208600000X | Surgeon | 232599 | NY |
N | 208200000X | Surgeon | A82349 | CA |
N | 208600000X | Surgeon | A82349 | CA |
N | 2086S0105X | Surgery of the Hand | 232599 | NY |
N | 2086S0105X | Surgery of the Hand | A82349 | CA |
N | 2086S0122X | Plastic and Reconstructive Surgery | 232599 | NY |
N | 2086S0122X | Plastic and Reconstructive Surgery | A82349 | CA |
N | 208D00000X | General Practice Physician | 232599 | NY |
N | 208D00000X | General Practice Physician | A82349 | CA |
NPI | 1710946868 |
---|---|
Provider Name | Dr. Edward P. Miranda |
First Address | San Francisco, CA 94102 |
Second Address | San Francisco, CA 94102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2006 |
Last Update Date | 28/09/2017 |