Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 000000G46020 | CA |
NPI | 1033299292 |
---|---|
Provider Name | Jeffrey Milliken |
First Address | Los Angeles, CA 90051-0347 |
Second Address | Orange, CA 92868 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 26/02/2008 |