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General NPI Number Information
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NPI Number | 1437319332
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Entity Type | Organization
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Legal Business Name | BOBBY R MILLER MD MEDICAL CORPORATION
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Dates
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Enumeration Date | 06/13/2008
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Last Update Date | 03/10/2015
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Provider Practice Location Address
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Address Line | 1011 N CHINA LAKE BLVD STE. A
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City | RIDGECREST
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State | CA
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Zip | 93555-3130
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Country | US
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Telephone | 760-499-7222
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Fax | 760-499-7228
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Provider Business Mailing Address
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Address Line | PO BOX 129
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City | RIDGECREST
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State | CA
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Zip | 93556-0129
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Country | US
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Telephone | 760-499-7222
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Fax | 760-499-7228
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BOBBY RAY MILLER JR.
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Credential | MD
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Telephone | 760-499-7222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | C508842
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License Number State | CA
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