Active NPI
Bryan Miller
- Pharmacist
- Madera, CA
National Provider Identifier
1053736702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 55982
- Practice address
- 9300 Valley Childrens PL
Madera, CA 93636-8761 - Phone
- (559) 353-5000
- NPI assigned
- Mar 4, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 55982 | CA | Primary |
Addresses
Primary practice location
9300 Valley Childrens PL
Madera, CA 93636-8761
Mailing address
9300 Valley Childrens PL
Madera, CA 93636-8761
Phone (559) 353-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 250943 | Other | CA | NABP E-PROFILE ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55982 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393891200000",
"number": "1053736702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9300 VALLEY CHILDRENS PL",
"city": "MADERA",
"state": "CA",
"postal_code": "936368761",
"telephone_number": "559-353-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9300 VALLEY CHILDRENS PL",
"city": "MADERA",
"state": "CA",
"postal_code": "936368761",
"telephone_number": "559-353-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "BRYAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-03-04",
"last_updated": "2014-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "55982",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP E-PROFILE ID",
"identifier": "250943",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madera, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.