Most Relevant Information
Provider Data
| NPI Number: | 1003378944 |
| Provider Name: | MIRANDA G IDEAL CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 845670 |
Most Important Dates
| Enumeration Date: | 04/01/2019 |
| Last Updated: | 01/24/2023 |
Provider Practice Location
101 THE CITY DR S
ORANGE
CA
928683201
Practice Location Phone/Fax
| Phone: | 7148807812 |
| Fax: |
Provider Mailing Location
200 S MANCHESTER AVE STE 300
ORANGE
CA
928683219
Provider Mailing Phone/Fax
| Phone: | 7144562986 |
| Fax: |