MEDICARE: DR. CLAY ROBERT MILLER D.C.

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	111NX0800X	Orthopedic Chiropractor	16636	CA

General Provider Information

NPI Number	:	1154441103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLAY ROBERT MILLER D.C.

Provider Business Mailing Address
First Line	:	14341 BEACH BLVD
Second Line	:	STE. B
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-4561
Country	:	US
Telephone Number	:	714-373-2700
Fax Number	:	714-373-2701

Provider Business Practice Location Address
First Line	:	14341 BEACH BLVD
Second Line	:	STE. B
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-4561
Country	:	US
Telephone Number	:	714-373-2700
Fax Number	:	714-373-2701

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

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	07/08/2007

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