Basic Information
Provider Information
NPI: 1932128741
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MILES
FirstName: STEVEN
MiddleName: ALOYSIUS
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8631 WEST THIRD STREET
Address2: SUITE 1017E
City: LOS ANGELES
State: CA
PostalCode: 90048
CountryCode: US
TelephoneNumber: 4243639221
FaxNumber: 3102895917
Practice Location
Address1: 8631 WEST THIRD STREET
Address2: SUITE 1017E
City: LOS ANGELES
State: CA
PostalCode: 90048
CountryCode: US
TelephoneNumber: 4243639221
FaxNumber: 3102895917
Other Information
ProviderEnumerationDate: 07/19/2006
LastUpdateDate: 11/09/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003XG48908CAY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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