Provider Demographics
NPI:1427486687
Name:SHELDON A MILLER MD A PROFESSIONAL CORP
Entity type:Organization
Organization Name:SHELDON A MILLER MD A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-988-2644
Mailing Address - Street 1:6031 PALOMINO CIR
Mailing Address - Street 2:
Mailing Address - City:SOMIS
Mailing Address - State:CA
Mailing Address - Zip Code:93066-9739
Mailing Address - Country:US
Mailing Address - Phone:805-988-2644
Mailing Address - Fax:805-981-4423
Practice Address - Street 1:1600 N ROSE AVE
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-3722
Practice Address - Country:US
Practice Address - Phone:805-988-2644
Practice Address - Fax:805-981-4423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-28
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty