Provider Demographics
NPI:1548437569
Name:MILLER CHIROPRACTIC INC
Entity type:Organization
Organization Name:MILLER CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:619-579-8585
Mailing Address - Street 1:1183 E MAIN ST
Mailing Address - Street 2:STE. C
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-7165
Mailing Address - Country:US
Mailing Address - Phone:619-579-8585
Mailing Address - Fax:619-593-1685
Practice Address - Street 1:1183 E MAIN ST
Practice Address - Street 2:STE. C
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-7165
Practice Address - Country:US
Practice Address - Phone:619-579-8585
Practice Address - Fax:619-593-1685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18541111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC18541AMedicare PIN