Organization
EDWARD B. MILLER, M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD B MILLER M.D. (OWNER)
(530) 926-5990
Entity
Organization
Contact information
Practice address
914 PINE ST, MOUNT SHASTA, CA 96067-2143
(530) 926-7131
(530) 926-5740
Mailing address
635 LASSEN LN, MOUNT SHASTA, CA 96067-9003
(530) 926-5990
(530) 926-5740
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G27556
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006313
—
OR
01
—
00G275560
BLUE CROSS
CA
05
—
00G275560
—
CA
01
—
196211500
OWCP
CA
Enumeration date
11/14/2007
Last updated
01/23/2012
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