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Individual

ERIC MIYAMOTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
31872 COAST HWY, LAGUNA BEACH, CA 92651-6773
(949) 499-7288
Mailing address
PO BOX 7630, LAGUNA NIGUEL, CA 92607-7630

Taxonomy

Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
A38981
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A38981
CA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
A38981
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A389810
CA
Enumeration date
09/20/2006
Last updated
05/26/2016
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