Dee Jay Nery Miranda, MD | |
2155 Iron Point Rd, Folsom, CA 95630-8707 | |
(916) 817-5463 | |
Not Available |
Full Name | Dee Jay Nery Miranda |
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Gender | Male |
Speciality | Pediatrics |
Location | 2155 Iron Point Rd, Folsom, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295764926 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 40990 (Tennessee) | Secondary |
208000000X | Pediatrics | A101360 (California) | Primary |
Entity Name | Permanente Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
Mailing Address | Practice Location Address |
---|---|
Dee Jay Nery Miranda, MD 2155 Iron Point Rd, Folsom, CA 95630-8707 Ph: (916) 817-5463 | Dee Jay Nery Miranda, MD 2155 Iron Point Rd, Folsom, CA 95630-8707 Ph: (916) 817-5463 |
Karen D. Camfield, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2155 Iron Point Rd, Folsom, CA 95630 Phone: 916-817-5000 | |
Lenore Reeva Cs Youssefi, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2575 E. Bidwell Street, Suite 250, Folsom, CA 95630 Phone: 916-817-3700 Fax: 916-817-3721 | |
Sally J. Cullen, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2155 Iron Point Rd, Folsom, CA 95630 Phone: 916-817-5000 | |
Shiwaji Dattatray Pawar, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2155 Iron Point Rd, Folsom, CA 95630 Phone: 916-817-5438 Fax: 916-817-5415 | |
Mitra Choudri, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2155 Iron Point Rd, Folsom, CA 95630 Phone: 916-817-5000 | |
Dr. Randall Claud Hepworth, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1000 River Rock Dr, Ste 114, Folsom, CA 95630 Phone: 916-989-2086 Fax: 916-989-0367 |