Healthcare Provider Details

I. General information

NPI: 1144814070
Provider Name (Legal Business Name): ANTOINETTE MARIE MILLER AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2021
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 W MAGNOLIA BLVD STE 260
BURBANK CA
91506-1770
US

IV. Provider business mailing address

2211 W MAGNOLIA BLVD STE 260
BURBANK CA
91506-1770
US

V. Phone/Fax

Practice location:
  • Phone: 818-859-7730
  • Fax: 818-952-1130
Mailing address:
  • Phone: 818-859-7730
  • Fax: 818-952-1130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU958
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: