Healthcare Provider Details

I. General information

NPI: 1932311610
Provider Name (Legal Business Name): VICTORIA CHRISTINE MILLS M.M.S., PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 04/02/2021
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23181 VERDUGO DR STE 103A
LAGUNA HILLS CA
92653-1313
US

IV. Provider business mailing address

23181 VERDUGO DR STE 103A
LAGUNA HILLS CA
92653-1313
US

V. Phone/Fax

Practice location:
  • Phone: 949-366-1053
  • Fax:
Mailing address:
  • Phone: 949-366-1053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA 19069
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: