Provider Demographics
NPI:1528198488
Name:MILLER, DAVID HENRY (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:HENRY
Last Name:MILLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2934 GOLD PAN CT
Mailing Address - Street 2:SUITE 10
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-6135
Mailing Address - Country:US
Mailing Address - Phone:916-424-9545
Mailing Address - Fax:916-424-1580
Practice Address - Street 1:2934 GOLD PAN CT
Practice Address - Street 2:SUITE 10
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-6135
Practice Address - Country:US
Practice Address - Phone:916-424-9545
Practice Address - Fax:916-424-1580
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32850183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist