Provider Demographics
NPI:1891931945
Name:MILLER, EARL LEROY (PROBATION OFFICER II)
Entity Type:Individual
Prefix:MR
First Name:EARL
Middle Name:LEROY
Last Name:MILLER
Suffix:
Gender:M
Credentials:PROBATION OFFICER II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 W OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4512
Mailing Address - Country:US
Mailing Address - Phone:562-491-5807
Mailing Address - Fax:562-435-8523
Practice Address - Street 1:415 W OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4512
Practice Address - Country:US
Practice Address - Phone:562-491-5807
Practice Address - Fax:562-435-8523
Is Sole Proprietor?:No
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist