MEDICARE: DR. NATHAN A MILLER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0000X	Pain Medicine Physician	G76146	CA

General Provider Information

NPI Number	:	1073672473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATHAN A MILLER MD

Provider Business Mailing Address
First Line	:	6221 METROPOLITAN ST
Second Line	:	SUITE 201
City	:	CARLSBAD
State	:	CA
Zip	:	92009-3096
Country	:	US
Telephone Number	:	760-753-7127
Fax Number	:	760-607-0282

Provider Business Practice Location Address
First Line	:	6221 METROPOLITAN ST
Second Line	:	SUITE 201
City	:	CARLSBAD
State	:	CA
Zip	:	92009-3096
Country	:	US
Telephone Number	:	760-753-7127
Fax Number	:	760-607-0282

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	03/21/2011

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