Miller, Gregory Lee
Miller, Gregory Lee is an sole proprietor health care provider with primary practice located at 138 N Grant Ave , Manteca CA 95336-4601. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Miller, Gregory Lee can be contacted via phone (209) 823-7146.Contact Information
Primary practice address
138 N Grant Ave
Manteca CA 95336-4601
Phone: (209) 823-7146
Fax: (209) 823-0670
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 05909T | California |
Profile Details
| NPI number | 1043282262 |
|---|---|
| LBN Legal business name | Miller, Gregory Lee |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 2nd, 2006 |
| Last updated | Nov 12th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043282262 | NPPES |
| California | MEDICAID | SD0059090 | |
| California | Other | 45547 | |
| California | Other | SD0059090 | |
| California | Other | 3417 |
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