Individual
NOEL MINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868
(714) 456-7890
Mailing address
101 THE CITY DR S, ORANGE, CA 92868-3201
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
267525
MA
2085R0202X
Diagnostic Radiology Physician
Primary
153078
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267525
—
MA
Enumeration date
03/31/2016
Last updated
06/26/2018
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