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General NPI Number Information
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NPI Number | 1508122276
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Entity Type | Individual
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Provider Name | JOEL CLINTON MILLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/07/2012
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Last Update Date | 02/05/2020
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Provider Practice Location Address
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Address Line | 3630 E IMPERIAL HWY
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City | LYNWOOD
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State | CA
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Zip | 90262-2609
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Country | US
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Telephone | 858-243-1135
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Fax |
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Provider Business Mailing Address
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Address Line | 3767 PASEO PRIMARIO
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City | CALABASAS
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State | CA
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Zip | 91302-3055
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Country | US
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Telephone | 858-243-1135
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | C1-0011345
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A141177
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License Number State | CA
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