Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | G52487 | CA |
NPI | 1255317681 |
---|---|
Provider Name | Dr. William Bradley Miller |
First Address | Nevada City, CA 95959-2941 |
Second Address | Nevada City, CA 95959-2941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2005 |
Last Update Date | 15/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G524870 | (05) | CA |
A52275 | (02) |