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Individual

MR. MIEKO MCCALEB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
11301 WILSHIRE BLVD, LOS ANGELES, CA 90073-1003
(310) 478-3711
Mailing address
2019 W 41ST ST, LOS ANGELES, CA 90062-1417

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA16005
CA

Other

Enumeration date
01/31/2007
Last updated
07/08/2007
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