Basic Information
| Provider Information | |||||||||
| NPI: | 1821758111 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PIH HEALTH PHYSICIANS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1277 | ||||||||
| Address2: | |||||||||
| City: | WHITTIER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906091277 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5627895401 | ||||||||
| FaxNumber: | 5627895912 | ||||||||
| Practice Location | |||||||||
| Address1: | 399 E HIGHLAND AVE STE 424 | ||||||||
| Address2: | |||||||||
| City: | SAN BERNARDINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 924043870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9099493977 | ||||||||
| FaxNumber: | 2139771180 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2021 | ||||||||
| LastUpdateDate: | 12/28/2021 | ||||||||
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| AuthorizedOfficialLastName: | MIYAMOTO | ||||||||
| AuthorizedOfficialFirstName: | KEITH | ||||||||
| AuthorizedOfficialMiddleName: | S. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5627895401 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | 12/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
No ID Information.