Individual
MIGUEL ANGEL NIEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6305 COYLE AVE, CARMICHAEL, CA 95608-0438
(916) 961-6920
(916) 966-5063
Mailing address
3400 DATA DR, RANCHO CORDOVA, CA 95670-7956
(916) 379-2871
(916) 853-4730
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
G56040
CA
2085N0700X
Neuroradiology Physician
G56040
CA
2085R0202X
Diagnostic Radiology Physician
Primary
G56040
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G560400
MEDI-CAL
CA
01
—
300025732
RAILROAD MEDICARE
—
Enumeration date
07/06/2006
Last updated
02/10/2020
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