Healthcare Provider Details

I. General information

NPI: 1396159125
Provider Name (Legal Business Name): DAISY L MILLER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DAISY L WINTER D.O.

II. Dates (important events)

Enumeration Date: 06/19/2014
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N PEPPER AVE
COLTON CA
92324-1819
US

IV. Provider business mailing address

400 N PEPPER AVE
COLTON CA
92324-1819
US

V. Phone/Fax

Practice location:
  • Phone: 909-508-1000
  • Fax:
Mailing address:
  • Phone: 909-508-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number20A23383
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: