Provider Demographics
NPI:1679095319
Name:STEVEN A MILES, MD, APC
Entity Type:Organization
Organization Name:STEVEN A MILES, MD, APC
Other - Org Name:BIG THUNDER LOUD RIVER, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ALOYSIUS
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:424-363-9221
Mailing Address - Street 1:8631 WEST THIRD STREET
Mailing Address - Street 2:SUITE 1017E
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:424-363-9221
Mailing Address - Fax:
Practice Address - Street 1:8631 WEST THIRD STREET
Practice Address - Street 2:SUITE 1017E
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:424-363-9221
Practice Address - Fax:310-289-5917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-14
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG48908207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematologyGroup - Multi-Specialty