Basic Information
Provider Information
NPI: 1508038654
EntityType: 2
ReplacementNPI:  
OrganizationName: STEVEN A. MILES, M.D. A PROFESSIONAL CORPORATION
LastName:  
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Mailing Information
Address1: 8700 BEVERLY BLVD
Address2: ROOM #AC1042-A
City: WEST HOLLYWOOD
State: CA
PostalCode: 900481804
CountryCode: US
TelephoneNumber: 3104237554
FaxNumber: 3106593928
Practice Location
Address1: 8700 BEVERLY BLVD
Address2: ROOM #AC1042-A
City: WEST HOLLYWOOD
State: CA
PostalCode: 900481804
CountryCode: US
TelephoneNumber: 3104237554
FaxNumber: 3106593928
Other Information
ProviderEnumerationDate: 03/28/2008
LastUpdateDate: 10/19/2011
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AuthorizedOfficialLastName: MILES
AuthorizedOfficialFirstName: STEVEN
AuthorizedOfficialMiddleName: ALOYSIUS
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 3104237554
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003XG48908CAY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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