Individual
JOSE RENE MIRANDA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10 WOODLAND RD, SAINT HELENA, CA 94574-9554
(707) 963-3611
Mailing address
10 WOODLAND RD, SAINT HELENA, CA 94574-9554
(707) 963-3611
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
CAG46935
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CAG46935
STATE LICENSE NUMBER
CA
Enumeration date
12/02/2005
Last updated
07/09/2007
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