MEDICARE: JOANNE 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	HA3782	CA
2	237700000X	Hearing Instrument Specialist	HA3782	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HA3782	OTHER	CA	STATE LICENSE

General Provider Information

NPI Number	:	1962628123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNE MILLER

Provider Business Mailing Address
First Line	:	4421 OSPREY ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92107-4030
Country	:	US
Telephone Number	:	619-823-4145
Fax Number	:

Provider Business Practice Location Address
First Line	:	1277 ENCINITAS BLVD
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92024-2843
Country	:	US
Telephone Number	:	760-634-1469
Fax Number	:

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

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	04/22/2022

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