Individual
DR. IDELEE GARCIA MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1230 7TH AVE, KAISER PERMANENTE LONGVIEW KELSO MEDICAL OFFICE, LONGVIEW, WA 98632-3166
(360) 636-2400
Mailing address
9 KOSTER BLVD APT 2A, EDISON, NJ 08837-4319
(848) 260-0025
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD 60122504
WA
Other
Enumeration date
01/11/2010
Last updated
02/04/2022
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