Individual
MR. JUSTIN MIYAMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6041 CADILLAC AVE, LOS ANGELES, CA 90034-1702
(323) 857-2000
Mailing address
6041 CADILLAC AVE, LOS ANGELES, CA 90034-1702
(323) 857-2000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A136811
CA
208000000X
Pediatrics Physician
ML60292840
WA
Other
Enumeration date
03/20/2012
Last updated
12/06/2021
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