Provider Demographics
NPI:1710900881
Name:MILES, LAUGHTON E (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:LAUGHTON
Middle Name:E
Last Name:MILES
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10300 W LOYOLA DR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-6510
Mailing Address - Country:US
Mailing Address - Phone:650-917-9982
Mailing Address - Fax:650-949-1420
Practice Address - Street 1:10300 W LOYOLA DR
Practice Address - Street 2:
Practice Address - City:LOS ALTOS HILLS
Practice Address - State:CA
Practice Address - Zip Code:94024-6510
Practice Address - Country:US
Practice Address - Phone:650-917-9982
Practice Address - Fax:650-949-1420
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25412207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24427Medicare UPIN