Individual
DR. THEODORE R MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 DIVISADERO ST, SAN FRANCISCO, CA 94143-0001
(415) 353-7855
(415) 353-7676
Mailing address
1635 DIVISADERO ST, STE 625, BOX 1821, SAN FRANCISCO, CA 94143-0001
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
C35046
CA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
C35046
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C350460
—
CA
Enumeration date
05/01/2006
Last updated
06/09/2008
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