person
Dr. Conrad J R Miranda IV, MD
General Practice Physician in Northridge, California
NPI 1073554168

Conrad J R Miranda IV is a General Practice Physician based in Northridge, CA. Conrad J R Miranda IV practices in Northridge, CA and has the professional credentials of MD. The NPI Number for Conrad J R Miranda IV is 1073554168 and holds a License No. C51139 (California).

The current practice location address for Conrad J R Miranda IV is 9900 Balboa Blvd, Northridge, CA and can be reached out via phone at 818-701-0017 and via fax at 818-701-0073.

Location: 9900 Balboa Blvd, Northridge, CA, 91325-5403
person
Provider Profile Details
NPI Number
1073554168
Provider Name
Conrad J R Miranda IV
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
9900 Balboa Blvd, Northridge, CA, 91325-5403
Phone Number
818-701-0017
Fax Number
818-701-0073
Provider Enumeration Date
06/09/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
C51139 01 CA PHYSICIAN CA LICENSE
institution
Provider Business Practice Location Address Details
Address
9900 Balboa Blvd
City
State
Zip
91325-5403
Phone Number
818-701-0017
Fax Number
818-701-0073
person
Provider Business Mailing Address Details
Address
9900 Balboa Blvd
City
State
Zip
91325-5403
Phone Number
818-701-0017
Fax Number
818-701-0073
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
C51139 (California)
Definition
Definition to come...
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