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General NPI Number Information
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NPI Number | 1639120579
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Entity Type | Individual
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Provider Name | STEPHEN J MILLMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 5820 STONERIDGE MALL RD SUITE 230
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City | PLEASANTON
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State | CA
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Zip | 94588-3274
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Country | US
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Telephone | 925-224-7281
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Fax | 925-833-1911
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Provider Business Mailing Address
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Address Line | PO BOX 199
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City | SAN RAMON
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State | CA
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Zip | 94583-0199
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Country | US
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Telephone | 925-224-7281
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Fax | 925-833-1911
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | C33155
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License Number State | CA
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