Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | A70329 | CA |
N | 207RP1001X | Pulmonary Disease | A70329 | CA |
NPI | 1023092871 |
---|---|
Provider Name | John S Millar |
First Address | Sacramento, CA 95817-1460 |
Second Address | Sacramento, CA 95817-1460 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2005 |
Last Update Date | 14/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A70329 | STATE LICENSE NUMBER (01) | CA |
H41351 | (02) |