Healthcare Provider Details

I. General information

NPI: 1902648256
Provider Name (Legal Business Name): CAYDEN MILLER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2024
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 S VAL VISTA DR STE C101
GILBERT AZ
85297-7318
US

IV. Provider business mailing address

3530 S VAL VISTA DR STE C101
GILBERT AZ
85297-7318
US

V. Phone/Fax

Practice location:
  • Phone: 480-840-9155
  • Fax: 480-840-9320
Mailing address:
  • Phone: 480-840-9155
  • Fax: 480-840-9320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11524
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: