Provider Demographics
NPI:1790818797
Name:MILLER, ANGELA K (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:K
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1050 WISCONSIN ST
Mailing Address - Street 2:POTRERO HILL HEALTH CTR.
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-3328
Mailing Address - Country:US
Mailing Address - Phone:415-648-3022
Mailing Address - Fax:415-550-1639
Practice Address - Street 1:1050 WISCONSIN ST
Practice Address - Street 2:POTRERO HILL HEALTH CTR.
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-3328
Practice Address - Country:US
Practice Address - Phone:415-648-3022
Practice Address - Fax:415-550-1639
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72109207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
975912OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER
H86093Medicare UPIN