Provider Demographics
NPI:1073672473
Name:MILLER, NATHAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:A
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6221 METROPOLITAN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-3096
Mailing Address - Country:US
Mailing Address - Phone:760-753-7127
Mailing Address - Fax:760-607-0282
Practice Address - Street 1:6221 METROPOLITAN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-3096
Practice Address - Country:US
Practice Address - Phone:760-753-7127
Practice Address - Fax:760-607-0282
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG76146208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
W16199Medicare ID - Type Unspecified
F64847Medicare UPIN