Individual provider Active NPI

Mia Lauren Miller, O.D.

  • Optometrist
  • El Cerrito, CA
National Provider Identifier
1194873778
Registry record updated Sep 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7996 Issued in CA
Practice address
180 El Cerrito PLZ
El Cerrito, CA 94530-4002
Phone
(510) 526-2242
Fax
(510) 526-2748
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7996 CA Primary

Addresses

Primary practice location

180 El Cerrito PLZ
El Cerrito, CA 94530-4002

Mailing address

180 El Cerrito PLZ
El Cerrito, CA 94530-4002
Phone (510) 526-2242

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
7996CAMDOptometrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1194873778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 EL CERRITO PLZ",
            "city": "EL CERRITO",
            "state": "CA",
            "postal_code": "945304002",
            "telephone_number": "510-526-2242",
            "fax_number": "510-526-2748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 EL CERRITO PLZ",
            "city": "EL CERRITO",
            "state": "CA",
            "postal_code": "945304002",
            "telephone_number": "510-526-2242",
            "fax_number": "510-526-2748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MIA",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cerrito, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.