Individual
KENNETH JOEL MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1360 W 6TH ST, SUITE 215, SAN PEDRO, CA 90732-3514
(310) 547-9991
(310) 547-2389
Mailing address
1360 W 6TH ST, SUITE 215, SAN PEDRO, CA 90732-3514
(310) 547-9991
(310) 547-2389
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
C30205
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0042930
—
CA
Enumeration date
07/26/2006
Last updated
05/31/2012
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