Healthcare Provider Details

I. General information

NPI: 1700791506
Provider Name (Legal Business Name): WENDY MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6370 W SUNSET BLVD # 100
LOS ANGELES CA
90028-7323
US

IV. Provider business mailing address

732 S SPRING ST APT 608
LOS ANGELES CA
90014-3050
US

V. Phone/Fax

Practice location:
  • Phone: 281-635-8535
  • Fax:
Mailing address:
  • Phone: 281-635-8535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: