Provider Demographics
NPI:1962779652
Name:PIH HEALTH PHYSICIANS
Entity type:Organization
Organization Name:PIH HEALTH PHYSICIANS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:S
Authorized Official - Last Name:MIYAMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-789-5401
Mailing Address - Street 1:P O BOX 1277
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90609-1277
Mailing Address - Country:US
Mailing Address - Phone:562-789-5401
Mailing Address - Fax:
Practice Address - Street 1:121 W WHITTIER BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-0903
Practice Address - Country:US
Practice Address - Phone:562-694-2500
Practice Address - Fax:562-694-2577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-23
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83764207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty