Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jaclyn Miyamoto, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1477902104

Jaclyn Miyamoto, MD is a Family Practice in Fontana, California. Graduated from University of California, Davis School of Medicine in 2018, 8 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment.

Years since qualifying
8
Trained at
University of California, Davis School of Medicine
In the registry since
2016
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

17234 Valley Blvd
Fontana, CA 92335
Phone: (909) 427-5084
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1477902104
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 3, 2016
Last updated in NPPESDecember 6, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
Graduated 2018 (8 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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