Provider Demographics
NPI:1730103938
Name:MILLER, CHRISTOPHER JOHN (DC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JOHN
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 1:1465 ENCINITAS BLVD
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2951
Mailing Address - Country:US
Mailing Address - Phone:760-753-6808
Mailing Address - Fax:
Practice Address - Street 1:1465 ENCINITAS BLVD STE H
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2951
Practice Address - Country:US
Practice Address - Phone:760-753-6808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11989111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC011989OtherBLUE SHIELD OF CA.
CADC011989OtherBLUE SHIELD OF CA.
CADC11989Medicare ID - Type Unspecified