Provider Demographics
NPI:1063470391
Name:MIEL, RUFINA PAMELA MAE TUYAC (MD)
Entity Type:Individual
Prefix:
First Name:RUFINA PAMELA MAE
Middle Name:TUYAC
Last Name:MIEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18000 STUDEBAKER RD STE 800
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2671
Mailing Address - Country:US
Mailing Address - Phone:562-735-3226
Mailing Address - Fax:
Practice Address - Street 1:11100 WARNER AVE STE 214
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7511
Practice Address - Country:US
Practice Address - Phone:714-594-7820
Practice Address - Fax:562-869-1281
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10316207R00000X
AZ43195207RX0202X
CAC153805207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ520064Medicaid
NV002018799Medicaid
NV110245881OtherRAILROAD MEDICARE
AZZ143025OtherMEDICARE
NVH74353Medicare UPIN
NV36996Medicare ID - Type UnspecifiedMEDICARE NUMBER