Provider Demographics
NPI:1154151157
Name:MIDEO HEALTH OF CALIFORNIA INC
Entity type:Organization
Organization Name:MIDEO HEALTH OF CALIFORNIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FERDINANDO
Authorized Official - Middle Name:L
Authorized Official - Last Name:MIRARCHI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:844-643-3648
Mailing Address - Street 1:900 STATE ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-1419
Mailing Address - Country:US
Mailing Address - Phone:814-434-4824
Mailing Address - Fax:330-451-4172
Practice Address - Street 1:1267 SOUTH LOS ROBLES AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-4316
Practice Address - Country:US
Practice Address - Phone:844-643-3648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty