Mirandahealth Medical Center Inc a Professional Nursing Corporation

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MIRANDAHEALTH MEDICAL CENTER INC A PROFESSIONAL NURSING CORPORATION

Practice address

1222 Sephos St
Manteca, CA 95337-8079

Phone

(209) 456-4323

NPI assigned

Jun 3, 2024

Organization subpart

No

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

Authorized official

Name

Raydel Miranda, ARNP-BCNPI 1770856890

Title

Ceo

Phone

(209) 456-4323

Specialties & licenses 2

Addresses

Practitioners 1

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

• Raydel Miranda, ARNP-BC

  • Family Nurse Practitioner
  • Turlock, CA
  • NPI 1770856890
  NPD Authorized official

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1730920141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 SEPHOS ST",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953378079",
            "telephone_number": "209-456-4323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 SEPHOS ST",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953378079",
            "telephone_number": "209-456-4323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRANDAHEALTH MEDICAL CENTER INC A PROFESSIONAL NURSING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-02",
        "status": "A",
        "authorized_official_last_name": "MIRANDA",
        "authorized_official_first_name": "RAYDEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-456-4323",
        "authorized_official_credential": "ARNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Lee Miller, OD
• Howard Charles Miller, DPM
• Max William Miller, MD
• Matthew Hoyt Milnes, D.D.S.
• Marilou Ancheta Miranda
• Vishal Kumar Mittal, FNP
• Mircea Catalin Mitu, DDS
• Tonisha Mixon
• Hitshkumar Manubhai Modi, D.D.S
• Jayshree Mahesh Modi, RPH

• Primary Care Clinic/Center in Manteca, CA
• Providers in Manteca, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.