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Individual
DR. GABRIEL MIRANDA
Active
Individual
DR. GABRIEL MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A038721
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A387212
—
CA
01
—
A038721
OTHER PRIVATE INS.PROV.NO
CA
01
—
A0387210
BLUE SHIELD PROVIDER NUM.
CA
Enumeration date
02/23/2006
Last updated
07/29/2010
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