Provider Demographics
NPI:1245753839
Name:MILES, SHERYL (PA)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:MILES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:120 N MILLER ST STE C
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-4557
Mailing Address - Country:US
Mailing Address - Phone:805-574-1000
Mailing Address - Fax:805-574-1300
Practice Address - Street 1:120 N MILLER ST STE C
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-4557
Practice Address - Country:US
Practice Address - Phone:805-574-1000
Practice Address - Fax:805-574-1300
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-25
Last Update Date:2021-04-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL9110488363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant