Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | G16932 | CA |
NPI | 1124160163 |
---|---|
Provider Name | Dr. Bruce Lawrence Miller |
First Address | Beverly Hills, CA 90210-4709 |
Second Address | Beverly Hills, CA 90210-4709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 15/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000G169320 | (05) | CA |
A90458 | (02) | CA |