Individual
CARLOS GUSTAVO TERAN MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
847 W CHILDS AVE, MERCED, CA 95341-6862
(209) 383-7441
(209) 383-7813
Mailing address
737 W CHILDS AVE, MERCED, CA 95341-6805
(209) 383-1848
(209) 383-1296
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35. 099330
OH
208000000X
Pediatrics Physician
Primary
A119549
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A119549
CA MEDICAL LICENSE
CA
Enumeration date
07/26/2012
Last updated
03/06/2013
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