Organization
RAUL A MIRANDE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAUL A MIRANDE M.D. (PRESIDENT)
(541) 880-2881
Entity
Organization
Contact information
Practice address
2664 CAMPUS DR, KLAMATH FALLS, OR 97601-1105
(541) 880-2881
(541) 883-2250
Mailing address
PO BOX 5109, KLAMATH FALLS, OR 97601-0119
(541) 882-1540
(541) 882-2583
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD19229
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
073143
—
OR
Enumeration date
07/06/2006
Last updated
08/21/2009
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