Provider Demographics
NPI:1073395851
Name:MIANI GIRON, M.D.
Entity Type:Organization
Organization Name:MIANI GIRON, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MIANI
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-359-2396
Mailing Address - Street 1:21815 SATICOY ST UNIT 31
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-4893
Mailing Address - Country:US
Mailing Address - Phone:310-359-2396
Mailing Address - Fax:213-275-2226
Practice Address - Street 1:21815 SATICOY ST
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91304-4885
Practice Address - Country:US
Practice Address - Phone:310-359-2396
Practice Address - Fax:213-275-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health