Provider Demographics
NPI:1568882660
Name:MILLER, BRET DELANE
Entity Type:Individual
Prefix:
First Name:BRET
Middle Name:DELANE
Last Name:MILLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 E. PLAZA DR. SUITE 6
Mailing Address - Street 2:MARIAN INFUSION SERVICES
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454
Mailing Address - Country:US
Mailing Address - Phone:805-739-3810
Mailing Address - Fax:805-739-3851
Practice Address - Street 1:2995 MCMILLAN AVE STE 196
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-6769
Practice Address - Country:US
Practice Address - Phone:805-546-0208
Practice Address - Fax:805-546-0964
Is Sole Proprietor?:No
Enumeration Date:2014-04-16
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA389841835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist