Provider Demographics
NPI:1194708289
Name:MILLER, ROBERT MARTIN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MARTIN
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7345 MEDICAL CENTER DRIVE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1952
Mailing Address - Country:US
Mailing Address - Phone:818-884-8044
Mailing Address - Fax:818-884-8196
Practice Address - Street 1:7345 MEDICAL CENTER DRIVE
Practice Address - Street 2:SUITE 160
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1952
Practice Address - Country:US
Practice Address - Phone:818-884-8044
Practice Address - Fax:818-884-8196
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA20197207ND0900X, 207NI0002X, 207NS0135X
CA20197207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological Immunology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D0557210OtherCLIA
CA00A201970OtherMEDICAL
CA00A201970OtherMEDICAL
CA05D0557210OtherCLIA