Miller, Theodore R

Miller, Theodore R is an individual health care provider with primary practice located at 1600 Divisadero St , San Francisco CA 94143-0001. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anatomic Pathology, Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine. Allopathic & Osteopathic Physicians / Anatomic Pathology is his primary health care specialty. Miller, Theodore R can be contacted via phone (415) 353-7855.

Contact Information

Primary practice address
1600 Divisadero St San Francisco CA 94143-0001
Phone: (415) 353-7855
Fax: (415) 353-7676
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology 207ZP0101X C35046 California
Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine 207ZP0105X C35046 California

Profile Details

NPI number 1518924612
LBN Legal business name Miller, Theodore R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated Jun 9th, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518924612 NPPES
California MEDICAID 00C350460

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