Organization
JEAN T MIYASHITA MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN MIYASHITA MD (OWNER)
(818) 343-1700
Entity
Organization
Contact information
Practice address
18411 CLARK ST STE 103, TARZANA, CA 91356-3527
(818) 343-1700
(818) 343-1738
Mailing address
18411 CLARK ST STE 103, TARZANA, CA 91356-3527
(818) 343-1700
(818) 343-1738
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
G79761
CA
Other
Enumeration date
09/13/2007
Last updated
06/12/2008
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