Organization
KENNETH A MILLER M D MED CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH A MILLER M.D. (PRESIDENT)
(408) 356-9111
Entity
Organization
Contact information
Practice address
14527 S BASCOM AVE, LOS GATOS, CA 95032-2003
(408) 356-9111
(408) 365-9113
Mailing address
14527 S BASCOM AVE, LOS GATOS, CA 95032-2003
(408) 356-9111
(408) 365-9113
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G223300
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G223300
CAL ID
CA
Enumeration date
08/31/2006
Last updated
03/07/2023
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