Individual
BRUCE DEAN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1004 FOWLER WAY, SUITE 6, PLACERVILLE, CA 95667-5746
(530) 626-1602
(530) 626-8636
Mailing address
1004 FOWLER WAY, SUITE 6, PLACERVILLE, CA 95667-5746
(530) 626-1602
(530) 626-8636
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G29102
CA
207ND0900X
Dermatopathology Physician
G29102
CA
207NS0135X
Procedural Dermatology Physician
G29102
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G2910204
—
CA
Enumeration date
09/14/2006
Last updated
10/14/2010
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