Individual
MR. JASON MIYAMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS ATC
Contact information
Practice address
1500 OWENS ST, SUITE 170, SAN FRANCISCO, CA 94158-2334
(415) 885-3819
Mailing address
1500 OWENS ST, SUITE 170, SAN FRANCISCO, CA 94158-2334
(415) 885-3819
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/20/2014
Last updated
09/28/2016
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