Individual
IVANA MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
44139 MONTEREY AVE STE B, PALM DESERT, CA 92260-8700
(760) 773-4411
Mailing address
11737 MANUEL AVE, LOMA LINDA, CA 92354-6757
(909) 952-7162
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
772613
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95001332
CA
Other
Enumeration date
06/04/2014
Last updated
01/07/2022
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