Healthcare Provider Details

I. General information

NPI: 1922364488
Provider Name (Legal Business Name): SIHAM SOBHAN MILLER L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2012
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27450 YNEZ RD STE 100
TEMECULA CA
92591-4649
US

IV. Provider business mailing address

33253 POPPY ST
TEMECULA CA
92592-1341
US

V. Phone/Fax

Practice location:
  • Phone: 951-383-4333
  • Fax:
Mailing address:
  • Phone: 619-764-9455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number14638
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: