| Miller Medical & Wellness Clinic A Professional Medical Corp | |
|
28240 Agoura Rd Suite102 Agoura Hills CA 91301-2485 | |
| (818) 706-9690 | |
| (818) 706-9692 |
| Full Name | Miller Medical & Wellness Clinic A Professional Medical Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 28240 Agoura Rd, Agoura Hills, California |
| Authorized Official Name and Position | David Roy Miller (CEO) |
| Authorized Official Contact | 8187069690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miller Medical & Wellness Clinic A Professional Medical Corp 28240 Agoura Rd Suite102 Agoura Hills CA 91301-2485 Ph: (818) 706-9690 | Miller Medical & Wellness Clinic A Professional Medical Corp 28240 Agoura Rd Suite102 Agoura Hills CA 91301-2485 Ph: (818) 706-9690 |
| NPI Number | 1659392330 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 02/18/2020 |
| Medicare PECOS PAC ID | 7113928011 |
|---|---|
| Medicare Enrollment ID | O20070119000273 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659392330 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A54820 (California) | Primary |
| Provider Name | David R Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912958257 PECOS PAC ID: 8022019934 Enrollment ID: I20070119000327 |
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