Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | DC0228350 | CA |
N | 111NX0100X | Occupational Health | DC0228350 | CA |
NPI | 1528283298 |
---|---|
Provider Name | Dr. Layn F Miller |
First Address | Fountain Valley, CA 92708-6750 |
Second Address | Fountain Valley, CA 92708-6750 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 13/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
33-0973520 | TAX ID (01) | CA |
U71520 | (02) | CA |