MIYOCO MEDICAL CENTER INC. (NPI# 1285937631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285937631 |
| Entity Type | Organization |
| Organization Name | MIYOCO MEDICAL CENTER INC. |
| Practice Address |
15975 Harbor Blvd Fountain Valley CA 92708-1303 |
| Practice Telephone | 7145466575 |
| Practice Fax Number | 7145519411 |
| Mailing Telephone | 7145466575 |
| Mailing Fax Number | 7145519411 |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2013-09-09 |
| Authorized Official Name | DR. HIEP TRUONG (OWNER) |
| Authorized Official Telephone | 7145466575 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
A45852 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1578520151 | 05 |
| Street Address |
15975 HARBOR BLVD |
| City | FOUNTAIN VALLEY |
| State | CA |
| Zip Code | 92708-1303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295799534 | Kinh Tu Tran | Family Medicine | 15975 Harbor Blvd, Fountain Valley, CA 92708-1303 | 2006-04-13 |
| 1831799071 | Vu Nguyen Thuan Truong | Nurse Practitioner | 15975 Harbor Blvd, Fountain Valley, CA 92708-1303 | 2020-10-27 |
| 1356739767 | Marie Shyrell Basa | Nurse Practitioner | 15975 Harbor Blvd, Fountain Valley, CA 92708-1303 | 2015-01-07 |
| 1326319252 | Minh-tri Nguyen Dental Corp. | Dentist | 15975 Harbor Blvd, Fountain Valley, CA 92708-1303 | 2012-01-24 |
| 1245306349 | Minh-tri Huynh Nguyen | Dentist | 15975 Harbor Blvd, Fountain Valley, CA 92708-1303 | 2006-11-28 |
| 1225110968 | Julie C Cheng | Pediatrics | 15975 Harbor Blvd, Fountain Valley, CA 92708-1303 | 2006-10-20 |
| 1578520151 | Hiep Truong | Obstetrics & Gynecology | 15975 Harbor Blvd, Fountain Valley, CA 92708-1303 | 2006-04-27 |
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| 1295205425 | Alexander Nee Dds Inc | Dentist | 337 S Rancho Santa Fe Rd, San Marcos, CA 92708 | 2018-11-30 |
| 1093293052 | Claudia Raquel Santos | Physical Therapist | 18384 Brookhurst Street, Fountain Valley, CA 92708 | 2018-08-01 |
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| 1992297881 | Ereny Abdelmalak Metry | Pharmacist | 9064 Daffodil Ave, Fountain Valley, CA 92708 | 2018-06-06 |
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| 1932622347 | Mayra Alejandra Guerra | Social Worker | 18350 Mt Langley St, Suite 200, Fountain Valley, CA 92708 | 2017-07-18 |
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| 1871022277 | Cathy A Castagna-petersen | Counselor | 10529 Slater Avenue, Fountain Valley, CA 92708 | 2017-06-08 |
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| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821488438 | Ob/gyn University Associates- Fountain Valley | Clinic/Center | 11190 Warner Ave, Suite 402, Fountain Valley, CA 92708-4019 | 2015-02-03 |
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| City | FOUNTAIN VALLEY |
| Zip Code | 92708 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.