Organization
MIRANDA MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
A RICHARD MIRANDA M.D. (OWNER)
(208) 420-1319
Entity
Organization
Contact information
Practice address
94220 4TH ST, GOLD BEACH, OR 97444-7756
(208) 420-1319
(702) 453-5741
Mailing address
PO BOX 5498, TWIN FALLS, ID 83303-5498
(208) 420-1319
(702) 453-5741
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
MD151354
OR
Other
Enumeration date
11/07/2013
Last updated
11/07/2013
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