Organization
MIGA, INC
Active
Other names
Defiant Health
Organization subpart
No
Provider details
NPI number
Authorized official
WALT COOPER (CEO)
(719) 466-1661
Entity
Organization
Contact information
Practice address
1338 CARLOTTA AVENUE, BERKLEY, CA 94703
(415) 307-3302
Mailing address
68 HARRISON AVE STE 605, BOSTON, MA 02111-1929
(415) 307-3302
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
01/30/2025
Last updated
02/05/2025
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