Organization
D LARRY MILLER M D A PROFESSIONAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. D LARRY MILLER M.D. (OWNER)
(530) 877-4465
Entity
Organization
Contact information
Practice address
6585 CLARK RD STE 440, PARADISE, CA 95969-3500
(530) 877-4465
Mailing address
6585 CLARK RD STE 440, PARADISE, CA 95969-3500
(530) 877-4465
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
G206710
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G206710
—
CA
Enumeration date
06/30/2010
Last updated
02/20/2013
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