Healthcare Provider Details

I. General information

NPI: 1366487985
Provider Name (Legal Business Name): HOWARD MILLER, MD APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 11/17/2020
Certification Date: 11/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9834 GENESEE AVE STE 310
LA JOLLA CA
92037-1221
US

IV. Provider business mailing address

9834 GENESEE AVE STE 310
LA JOLLA CA
92037-1221
US

V. Phone/Fax

Practice location:
  • Phone: 619-457-0034
  • Fax: 858-764-9765
Mailing address:
  • Phone: 619-457-0034
  • Fax: 858-764-9765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberC38875
License Number StateCA

VIII. Authorized Official

Name: DR. HOWARD MILLER
Title or Position: PRESIDENT
Credential: MD
Phone: 858-457-0034