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Organization
ETNYRE AND MIKUNI MEDICAL CORPORATION
Active
Organization
ETNYRE AND MIKUNI MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANA J. DAUGHERTY (OFFICE MANAGER)
(805) 349-1202
Entity
Organization
Contact information
Practice address
301 S MILLER ST, SUITE 214, SANTA MARIA, CA 93454-5205
(805) 349-1202
(805) 349-0974
Mailing address
301 S MILLER ST, SUITE 214, SANTA MARIA, CA 93454-5205
(805) 349-1202
(805) 349-0974
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G074101
CA
Other
Enumeration date
08/30/2005
Last updated
11/03/2008
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