Healthcare Provider Details

I. General information

NPI: 1518309418
Provider Name (Legal Business Name): ALICE C MILLS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 09/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST
TORRANCE CA
90502-2004
US

IV. Provider business mailing address

1200 N STATE ST
LOS ANGELES CA
90033-1029
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-3528
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number656121
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: