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Individual

GLENN YUKIO MIYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
430 W BASELINE RD, CLAREMONT, CA 91711-1607
(909) 621-3916
(909) 625-0903
Mailing address
840 TOWNE CENTER DR, CHAPARRAL MEDICAL GROUP, POMONA, CA 91767-5900
(909) 398-1550
(909) 398-1573

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G70876
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G708760
CA
Enumeration date
03/24/2006
Last updated
12/03/2021
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