Provider Demographics
NPI:1861750895
Name:GEORGE G MIRANDA, MD, INC
Entity type:Organization
Organization Name:GEORGE G MIRANDA, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:GUINTO
Authorized Official - Last Name:MIRANDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-347-0600
Mailing Address - Street 1:26691 PLAZA
Mailing Address - Street 2:STE 200
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-8582
Mailing Address - Country:US
Mailing Address - Phone:949-347-0600
Mailing Address - Fax:949-347-0746
Practice Address - Street 1:26691 PLAZA
Practice Address - Street 2:STE 200
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-8582
Practice Address - Country:US
Practice Address - Phone:949-347-0600
Practice Address - Fax:949-347-0746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA106771207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty