MEDICARE: DR. ALLEN SCOTT 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	111NS0005X	Sports Physician Chiropractor	19031	CA
2	111NX0100X	Occupational Health Chiropractor	19031	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	19031	OTHER	CA	STATE LICENCE

General Provider Information

NPI Number	:	1588856868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLEN SCOTT MILLER D.C

Provider Business Mailing Address
First Line	:	304 S JONES BLVD # 1454
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-2623
Country	:	US
Telephone Number	:	626-399-6834
Fax Number	:

Provider Business Practice Location Address
First Line	:	304 S JONES BLVD # 1454
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-2623
Country	:	US
Telephone Number	:	626-399-6834
Fax Number	:	626-399-6834

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

Provider Enumeration Date	:	08/10/2007
Last Update Date	:	04/20/2021

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