Miller Medical & Wellness Clinic A Professional Medical Corp | |
28240 Agoura Rd Suite102 Agoura Hills CA 91301-2485 | |
(818) 706-9690 | |
(818) 706-9692 |
Full Name | Miller Medical & Wellness Clinic A Professional Medical Corp |
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Speciality | Family Medicine |
Location | 28240 Agoura Rd, Agoura Hills, California |
Authorized Official Name and Position | David Roy Miller (CEO) |
Authorized Official Contact | 8187069690 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Miller Medical & Wellness Clinic A Professional Medical Corp 28240 Agoura Rd Suite102 Agoura Hills CA 91301-2485 Ph: (818) 706-9690 | Miller Medical & Wellness Clinic A Professional Medical Corp 28240 Agoura Rd Suite102 Agoura Hills CA 91301-2485 Ph: (818) 706-9690 |
NPI Number | 1659392330 |
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Provider Enumeration Date | 07/21/2006 |
Last Update Date | 02/18/2020 |
Medicare PECOS PAC ID | 7113928011 |
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Medicare Enrollment ID | O20070119000273 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659392330 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | A54820 (California) | Primary |
Provider Name | David R Miller |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1912958257 PECOS PAC ID: 8022019934 Enrollment ID: I20070119000327 |
Provider Name | Michael Napolitano |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1871238907 PECOS PAC ID: 5991145344 Enrollment ID: I20240501004094 |
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