Larry Miller, D.O.

Individual provider Active NPI Family Medicine Physician · Prather, CA

NPI 1801967617 · NPPES record last updated Feb 24, 2014

Key facts

NPI
1801967617
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
20A9261 (CA)
Practice address
29369 Auberry Rd
102
Prather, CA 93651-9784
Phone
(559) 855-5390
Fax
(559) 855-5395
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A9261CAMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A9261 CA Yes

Addresses

Primary practice location

29369 Auberry Rd
102
Prather, CA 93651-9784

Mailing address

29369 Auberry Rd
102
Prather, CA 93651-9784
Phone (559) 855-5390

Other providers in Prather, CA

All providers in Prather, CA · Family Medicine Physician in California

Sources for this page

Verify at the official NPI Registry.