Alfonso P Miguel Jr MD Inc

Organization Active NPI Vascular Surgery Physician · Glendora, CA

NPI 1043393218 · NPPES record last updated Nov 29, 2007

Key facts

NPI
1043393218
Entity type
Organization (NPI type 2)
Primary specialty
Vascular Surgery Physician 2086S0129X
License
A23044 (CA)
Legal business name
ALFONSO P MIGUEL JR MD INC
Practice address
102 W Route 66
Suite a
Glendora, CA 91740-6247
Phone
(626) 914-3835
Fax
(626) 963-4613
NPI assigned
Oct 23, 2006
Organization subpart
No

Authorized official

Name
Alfonso P Miguel Jr., MD
Title
President & Owner
Phone
(626) 914-3835

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2086S0129X A23044 CA Yes

Addresses

Primary practice location

102 W Route 66
Suite a
Glendora, CA 91740-6247

Mailing address

102 W Route 66
Suite a
Glendora, CA 91740-6247
Phone (626) 914-3835

Other identifiers

IdentifierTypeStateIssuer
00A230440MedicaidCA

Other providers in Glendora, CA

All providers in Glendora, CA · Vascular Surgery Physician in California

Sources for this page

Verify at the official NPI Registry.