Provider Demographics
NPI:1437247236
Name:MILLER, RAY N (M D)
Entity Type:Individual
Prefix:DR
First Name:RAY
Middle Name:N
Last Name:MILLER
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 PACIFIC ST STE D2
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2819
Mailing Address - Country:US
Mailing Address - Phone:831-373-4461
Mailing Address - Fax:831-373-2198
Practice Address - Street 1:757 PACIFIC ST STE D2
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2819
Practice Address - Country:US
Practice Address - Phone:831-373-4461
Practice Address - Fax:831-373-2198
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG8272174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000G82720Medicare ID - Type Unspecified