Active NPI
Alfonso P Miguel, M.D.
- Vascular Surgery Physician
- Glendora, CA
National Provider Identifier
1124200381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- A23044
- Practice address
- 102 W Route 66 Ste a
Glendora, CA 91740-6247 - Phone
- (626) 914-3835
- Fax
- (626) 963-4613
- NPI assigned
- Nov 29, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | A23044 | CA | Primary |
Addresses
Primary practice location
102 W Route 66 Ste a
Glendora, CA 91740-6247
Mailing address
102 W Route 66 Ste a
Glendora, CA 91740-6247
Phone (626) 914-3835
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A230440 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A23044 | CA | MD | Vascular Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196294400000",
"number": "1124200381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 W ROUTE 66 STE A",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917406247",
"telephone_number": "626-914-3835",
"fax_number": "626-963-4613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 W ROUTE 66 STE A",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917406247",
"telephone_number": "626-914-3835",
"fax_number": "626-963-4613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIGUEL",
"first_name": "ALFONSO",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-11-29",
"last_updated": "2007-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "CA",
"license": "A23044",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A230440",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.