Individual
GARY Y MIYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
4060 4TH AVE STE 410, SAN DIEGO, CA 92103-2121
(619) 298-7109
(619) 298-8466
Mailing address
4060 4TH AVE STE 410, SAN DIEGO, CA 92103-2121
(619) 298-7109
(619) 298-8466
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G83926
CA
Other
Enumeration date
07/18/2006
Last updated
12/02/2011
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