Individual
KENICHI T MIYATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3393 G ST, D, MERCED, CA 95340-0964
(209) 230-9065
(209) 349-8511
Mailing address
3393 G ST, D, MERCED, CA 95340-0964
(209) 230-3065
(209) 349-8511
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A117496
CA
Other
Enumeration date
02/18/2007
Last updated
05/28/2013
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