Individual
MIKI WATANABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 880-7812
Mailing address
PO BOX 92900, PORTLAND, OR 97292-0900
(503) 261-6985
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
49294
CO
207R00000X
Internal Medicine Physician
MD165733
OR
207R00000X
Internal Medicine Physician
MT186972
PA
207RI0200X
Infectious Disease Physician
A102318
CA
208M00000X
Hospitalist Physician
49294
CO
208M00000X
Hospitalist Physician
Primary
A102318
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49294
CO LICENSE
CO
Enumeration date
08/16/2007
Last updated
07/29/2024
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