Kelly Miranda Physician Assistant Inc.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

KELLY MIRANDA PHYSICIAN ASSISTANT INC.

Practice address

26520 Cactus Ave
Moreno Valley, CA 92555-3927

Phone

(951) 486-5690

NPI assigned

Aug 20, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Kelly Miranda, PA-CNPI 1578671558

Title

Physician Assistant

Phone

(909) 229-6886

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly Miranda, PA-C, MPT

  • Physician Assistant
  • Moreno Valley, CA
  • NPI 1578671558
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566259200000",
    "number": "1245887645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12875 CANYONWIND RD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925039760",
            "telephone_number": "909-229-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26520 CACTUS AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925553927",
            "telephone_number": "951-486-5690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36485 Inland Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Wildomar",
            "state": "CA",
            "postal_code": "925959681",
            "country_code": "US",
            "telephone_number": "951-677-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KELLY MIRANDA PHYSICIAN ASSISTANT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-20",
        "last_updated": "2019-08-20",
        "status": "A",
        "authorized_official_last_name": "MIRANDA",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "909-229-6886",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Keith
• Kekes International LLC
• Isabella Keller
• Tesia Leane Kelley, M.S.
• Deandra Cassandra Kellman
• Christine Nicole Kendrick, CADC II
• Ashley Kennedy
• Ronald Norman Kent, MD
• Keri MV Dental Group, a Professional Corporation
• Keshawan Sampath Inc.

• Orthopaedic Surgery Physician in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.