Basic Information
| Provider Information | |||||||||
| NPI: | 1063470391 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MIEL | ||||||||
| FirstName: | RUFINA PAMELA MAE | ||||||||
| MiddleName: | TUYAC | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18000 STUDEBAKER RD STE 800 | ||||||||
| Address2: | |||||||||
| City: | CERRITOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907032671 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5627353226 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11100 WARNER AVE STE 214 | ||||||||
| Address2: | |||||||||
| City: | FOUNTAIN VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927087511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145947820 | ||||||||
| FaxNumber: | 5628691281 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2006 | ||||||||
| LastUpdateDate: | 11/19/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 10316 | NV | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RX0202X | 43195 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | 207RH0003X | C153805 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 520064 | 05 | AZ | MEDICAID | 002018799 | 05 | NV | MEDICAID | 110245881 | 01 | NV | RAILROAD MEDICARE | OTHER | Z143025 | 01 | AZ | MEDICARE | OTHER |