Active NPI
Thomas L. Miller, MD
- Diagnostic Radiology Physician
- Templeton, CA
National Provider Identifier
1750355152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- G56490
- Practice address
- 1310 Las Tablas Rd
Suite 103
Templeton, CA 93465-9737 - Phone
- (805) 461-7080
- Fax
- (805) 464-0243
- NPI assigned
- Feb 14, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | G56490 | CA | Primary |
Addresses
Primary practice location
1310 Las Tablas Rd
Suite 103
Templeton, CA 93465-9737
Mailing address
PO Box 2920
Atascadero, CA 93423-2920
Phone (805) 461-7080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G564900 | Medicaid | CA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G56490 | CA | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317254400000",
"number": "1750355152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2920",
"city": "ATASCADERO",
"state": "CA",
"postal_code": "934232920",
"telephone_number": "805-461-7080",
"fax_number": "805-464-0243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 LAS TABLAS RD",
"address_2": "SUITE 103",
"city": "TEMPLETON",
"state": "CA",
"postal_code": "934659737",
"telephone_number": "805-461-7080",
"fax_number": "805-464-0243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "THOMAS",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-14",
"last_updated": "2011-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "G56490",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G564900",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Templeton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.