Provider Demographics
NPI:1447305735
Name:MILLER, STEPHEN B (DC)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:B
Last Name:MILLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 E FOOTHILL BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-2527
Mailing Address - Country:US
Mailing Address - Phone:626-930-1355
Mailing Address - Fax:626-930-1354
Practice Address - Street 1:212 E FOOTHILL BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-2527
Practice Address - Country:US
Practice Address - Phone:626-930-1355
Practice Address - Fax:626-930-1354
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16749111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC16749Medicare ID - Type UnspecifiedMEDICARE NUMBER
CAT88009Medicare UPIN