Organization
ALFONSO P MIGUEL JR MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFONSO P MIGUEL JR. MD (PRESIDENT & OWNER)
(626) 914-3835
Entity
Organization
Contact information
Practice address
102 W ROUTE 66, SUITE A, GLENDORA, CA 91740-6247
(626) 914-3835
(626) 963-4613
Mailing address
102 W ROUTE 66, SUITE A, GLENDORA, CA 91740-6247
(626) 914-3835
(626) 963-4613
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
A23044
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A230440
—
CA
Enumeration date
10/23/2006
Last updated
11/29/2007
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