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NPI Code Detail

MEDICARE: DR. CAROL A. MILLER M.D.

MEDICARE: DR. CAROL A. MILLER M.D.
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
1174400000XSpecialistG34091CA

General Provider Information

NPI Number : 1821215427
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAROL A. MILLER M.D.
Provider Business Mailing Address
First Line : 2075 ROBIN RD
Second Line :
City : SAN MARINO
State : CA
Zip : 91108-2831
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1333 SAN PABLO, # MCA 340
Second Line :
City : LOS ANGELES
State : CA
Zip : 90089
Country : US
Telephone Number : 323-442-1602
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2007
Last Update Date : 07/08/2007

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