Individual
DANIEL RAUL MIRANDA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
855 N LARK ELLEN AVE STE L, WEST COVINA, CA 91791-1099
(626) 727-6282
(909) 992-3543
Mailing address
12007 FIDEL AVE, WHITTIER, CA 90605-3810
(562) 907-8176
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
49819
CA
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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