Provider Demographics
NPI:1619115664
Name:MILLER, JULIE ANN (DPM)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:MILLER-CORFMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:39755 MURRIETA HOT SPRINGS RD STE D130
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-9110
Mailing Address - Country:US
Mailing Address - Phone:951-698-4611
Mailing Address - Fax:
Practice Address - Street 1:39755 MURRIETA HOT SPRINGS RD STE D130
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-9110
Practice Address - Country:US
Practice Address - Phone:951-698-4611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-29
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3999213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU70523Medicare UPIN