Provider Demographics
NPI:1265460836
Name:MILES, DUNCAN ALEXANDER GN (MD)
Entity Type:Individual
Prefix:DR
First Name:DUNCAN
Middle Name:ALEXANDER GN
Last Name:MILES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 CAJON ST
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-5980
Mailing Address - Country:US
Mailing Address - Phone:909-509-5900
Mailing Address - Fax:909-509-5922
Practice Address - Street 1:555 CAJON ST
Practice Address - Street 2:SUITE B
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5980
Practice Address - Country:US
Practice Address - Phone:909-509-5900
Practice Address - Fax:909-509-5922
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA738332086S0122X
CAA0738332086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A738330Medicaid
CA00A738330Medicaid
CA00A738330Medicare PIN
H41355Medicare UPIN
00A738331Medicare ID - Type Unspecified