MEDICARE: DR. ROBERT MARTIN MILLER M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ND0900X	Dermatopathology Physician	A20197	CA
2	207NI0002X	Clinical & Laboratory Dermatological Immunology Physician	A20197	CA
3	207NP0225X	Pediatric Dermatology Physician	20197	CA
4	207NS0135X	Procedural Dermatology Physician	A20197	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	05D0557210	OTHER	CA	CLIA
2	00A201970	OTHER	CA	MEDICAL

General Provider Information

NPI Number	:	1194708289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT MARTIN MILLER M.D

Provider Business Mailing Address
First Line	:	7345 MEDICAL CENTER DRIVE
Second Line	:	SUITE 160
City	:	WEST HILLS
State	:	CA
Zip	:	91307-1952
Country	:	US
Telephone Number	:	818-884-8044
Fax Number	:	818-884-8196

Provider Business Practice Location Address
First Line	:	7345 MEDICAL CENTER DRIVE
Second Line	:	SUITE 160
City	:	WEST HILLS
State	:	CA
Zip	:	91307-1952
Country	:	US
Telephone Number	:	818-884-8044
Fax Number	:	818-884-8196

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	05/26/2010

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