Provider Demographics
NPI:1376518050
Name:MILLER, DALE EVERETT (MED, ATC)
Entity Type:Individual
Prefix:MR
First Name:DALE
Middle Name:EVERETT
Last Name:MILLER
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Gender:M
Credentials:MED, ATC
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Mailing Address - Street 1:27 ZABILA ST
Mailing Address - Street 2:
Mailing Address - City:RANCHO MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92694-1823
Mailing Address - Country:US
Mailing Address - Phone:714-348-4648
Mailing Address - Fax:714-997-3703
Practice Address - Street 1:501 N CRESCENT WAY
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5401
Practice Address - Country:US
Practice Address - Phone:714-999-3677
Practice Address - Fax:714-997-3703
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2014-12-15
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer