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1013775766
ANTONI A MIRANDA
LAKE ELSINORE, CA
NPI
1013775766
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2024-03-07
Last Update Date
2024-03-07
Business Address
ANTONI A MIRANDA CHW
31739 RIVERSIDE DR STE A1
LAKE ELSINORE, CA 92530-7818
Phone number: 951-245-0505
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Mailing Address
ANTONI A MIRANDA CHW
31739 RIVERSIDE DR
LAKE ELSINORE, CA 92530-7818
Phone number: 951-245-0506
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