Provider Demographics
NPI:1558469684
Name:MILLER, TERESA NADINE (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:NADINE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5905 SHENANDOAH AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90056-1425
Mailing Address - Country:US
Mailing Address - Phone:310-645-8771
Mailing Address - Fax:310-410-2150
Practice Address - Street 1:3565 DEL AMO BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-1637
Practice Address - Country:US
Practice Address - Phone:310-370-9032
Practice Address - Fax:310-793-4665
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2012-11-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG70438208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics