Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 1101 | CA |
NPI | 1073155677 |
---|---|
Provider Name | Dr. Emily Iris Angela Takeuchi Miller |
First Address | San Diego, CA 92121-4230 |
Second Address | San Diego, CA 92121-1429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2019 |
Last Update Date | 15/10/2019 |