Healthcare Provider Details

I. General information

NPI: 1588449060
Provider Name (Legal Business Name): ZACHARY GEORGE MILLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ZACH GEORGE MILLER

II. Dates (important events)

Enumeration Date: 08/31/2023
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

481 N 1ST ST
SAN JOSE CA
95112-4031
US

IV. Provider business mailing address

8945 GOLF LINKS RD
OAKLAND CA
94605-4124
US

V. Phone/Fax

Practice location:
  • Phone: 512-789-2782
  • Fax:
Mailing address:
  • Phone: 510-317-1444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: