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NPI Code Detail

MEDICARE: DR. MANDEL M. MILLER PHARM.D.

MEDICARE: DR. MANDEL M. MILLER PHARM.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
1183500000XPharmacist31161CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
131161OTHERCASTATE LICENSE

General Provider Information

NPI Number : 1962722603
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MANDEL M. MILLER PHARM.D.
Provider Business Mailing Address
First Line : 1674 CLEAR VIEW DR
Second Line :
City : BEVERLY HILLS
State : CA
Zip : 90210-2011
Country : US
Telephone Number : 310-271-7411
Fax Number :
Provider Business Practice Location Address
First Line : 300 N CANON DR
Second Line :
City : BEVERLY HILLS
State : CA
Zip : 90210-4705
Country : US
Telephone Number : 310-273-3561
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2010
Last Update Date : 06/04/2010

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