Medina, Miguel Angel

Medina, Miguel Angel is an individual health care provider with primary practice located at 795 E Second St. Suite 5, Pomona CA 91766-2007. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Medina, Miguel Angel can be contacted via phone (909) 865-2565.

Contact Information

Primary practice address
795 E Second St. Suite 5 Pomona CA 91766-2007
Phone: (909) 865-2565
Fax: (909) 865-2955
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA10383 California

Profile Details

NPI number 1447232640
LBN Legal business name Medina, Miguel Angel
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2005
Last updated Jun 20th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447232640 NPPES
California MEDICAID PA10383

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