Individual
ANTONI A MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CHW
Contact information
Practice address
31739 RIVERSIDE DR STE A1, LAKE ELSINORE, CA 92530-7818
(951) 245-0505
(951) 245-0999
Mailing address
31739 RIVERSIDE DR, LAKE ELSINORE, CA 92530-7818
(951) 245-0506
(951) 245-0999
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
CA
Other
Enumeration date
03/07/2024
Last updated
03/07/2024
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