Provider Demographics
NPI:1306968789
Name:MIRANDA & NIVER
Entity type:Organization
Organization Name:MIRANDA & NIVER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRANDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-269-2730
Mailing Address - Street 1:1649 12TH AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-3555
Mailing Address - Country:US
Mailing Address - Phone:415-269-2730
Mailing Address - Fax:563-639-6806
Practice Address - Street 1:1649 12TH AVE APT 2
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-3555
Practice Address - Country:US
Practice Address - Phone:415-269-2730
Practice Address - Fax:563-639-6806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology