Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A90116 | CA |
NPI | 1033387931 |
---|---|
Provider Name | Dr. Todd Covington Miller |
First Address | Los Alamitos, CA 90720-3567 |
Second Address | Newport Beach, CA 92663-3641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2008 |
Last Update Date | 26/02/2020 |