Provider Demographics
NPI:1639292402
Name:MILLER, PAMELA (L:AC)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:L:AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1427
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91017
Mailing Address - Country:US
Mailing Address - Phone:626-755-9864
Mailing Address - Fax:800-279-9342
Practice Address - Street 1:711 E. WALNUT ST.
Practice Address - Street 2:SUITE 305
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101
Practice Address - Country:US
Practice Address - Phone:626-755-9864
Practice Address - Fax:800-279-9342
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3644171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist