Peterson, Miles Ellis

Peterson, Miles Ellis is an individual health care provider with primary practice located at 8283 Grove Ave #104, Rancho Cucamonga CA 91730. He recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter, which is considered as his primary health care specialty. Peterson, Miles Ellis can be contacted via phone (909) 920-9906.

Contact Information

Primary practice address
8283 Grove Ave #104 Rancho Cucamonga CA 91730
Phone: (909) 920-9906
Fax: (909) 920-4151
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X AU1139 California
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X HA2555 California

Profile Details

NPI number 1376510313
LBN Legal business name Peterson, Miles Ellis
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2006
Last updated Jul 8th, 2007 - about 17 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 1376510313 NPPES
California MEDICAID AU0011390

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