Individual
DR. BRIAN M MIYAGISHIMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
525 PLAZA DR, SUITE 204A, SANTA MARIA, CA 93454-6953
(805) 925-3030
(805) 925-6453
Mailing address
504 PLAZA DR, SANTA MARIA, CA 93454-6917
(805) 349-8514
(805) 349-8958
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G69648
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5781301
AETNA
—
01
—
CB219047
MEDICARE ID
CA
Enumeration date
12/05/2005
Last updated
05/09/2017
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