Healthcare Provider Details

I. General information

NPI: 1073860896
Provider Name (Legal Business Name): DR LAYN MILLER DC APCC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2012
Last Update Date: 08/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10810 WARNER AVE STE 5
FOUNTAIN VALLEY CA
92708-3848
US

IV. Provider business mailing address

10810 WARNER AVE STE 5
FOUNTAIN VALLEY CA
92708-3848
US

V. Phone/Fax

Practice location:
  • Phone: 714-965-9999
  • Fax:
Mailing address:
  • Phone: 714-965-9999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberDC022835
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberDC022835
License Number StateCA

VIII. Authorized Official

Name: DR. LAYN FORD MILLER
Title or Position: CEO
Credential: DC
Phone: 714-965-9999