Healthcare Provider Details

I. General information

NPI: 1033387931
Provider Name (Legal Business Name): TODD COVINGTON MILLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2008
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10851 BLOOMFIELD ST
LOS ALAMITOS CA
90720-2504
US

IV. Provider business mailing address

10851 BLOOMFIELD ST
LOS ALAMITOS CA
90720-2504
US

V. Phone/Fax

Practice location:
  • Phone: 562-596-2925
  • Fax: 562-596-5703
Mailing address:
  • Phone: 562-596-2925
  • Fax: 562-596-5703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberA90116
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: