MEDICARE: MR. SCOTT SELLERS MILLER

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	237700000X	Hearing Instrument Specialist	HA8019	CA

General Provider Information

NPI Number	:	1578115606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT SELLERS MILLER

Provider Business Mailing Address
First Line	:	8041 GREENBACK LN
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95610-6909
Country	:	US
Telephone Number	:	916-721-0400
Fax Number	:	916-721-0434

Provider Business Practice Location Address
First Line	:	8041 GREENBACK LN
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95610-6909
Country	:	US
Telephone Number	:	916-721-0400
Fax Number	:	916-721-0434

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

Provider Enumeration Date	:	07/09/2019
Last Update Date	:	07/09/2019

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