Provider Demographics
NPI:1700837556
Name:MILLER, SEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 CAMINO DEL RIO SOUTH
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108
Mailing Address - Country:US
Mailing Address - Phone:619-947-7090
Mailing Address - Fax:619-947-7088
Practice Address - Street 1:2333 CAMINO DEL RIO SOUTH
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108
Practice Address - Country:US
Practice Address - Phone:619-947-7090
Practice Address - Fax:619-947-7088
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29927111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor