Provider Demographics
NPI:1124068010
Name:MILLER, DON EDWARD (PHD)
Entity type:Individual
Prefix:DR
First Name:DON
Middle Name:EDWARD
Last Name:MILLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:815 3RD AVE
Mailing Address - Street 2:SUITE 307
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-1310
Mailing Address - Country:US
Mailing Address - Phone:619-422-2458
Mailing Address - Fax:619-422-1905
Practice Address - Street 1:815 3RD AVE
Practice Address - Street 2:SUITE 307
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-1311
Practice Address - Country:US
Practice Address - Phone:619-422-2458
Practice Address - Fax:619-422-1905
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY3155103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA19815200OtherUS DEPT OF LABOR
CA6136836OtherUNITED HEALTH CARE
CA64087777OtherMULTI PLAN
CA00PL31550Medicaid
CA133921000OtherMAGELLAN
CA36836OtherUNITED HEALTH CARE
CA076465OtherVALUE OPTIONS
CA36836OtherUNITED HEALTH CARE