Healthcare Provider Details

I. General information

NPI: 1316867989
Provider Name (Legal Business Name): ANTHONY MARTIN MILLS M D A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8745 SANTA MONICA BLVD
WEST HOLLYWOOD CA
90069-4507
US

IV. Provider business mailing address

8745 SANTA MONICA BLVD
WEST HOLLYWOOD CA
90069-4507
US

V. Phone/Fax

Practice location:
  • Phone: 310-550-1010
  • Fax: 310-550-0650
Mailing address:
  • Phone: 310-550-1010
  • Fax: 310-550-0650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY MARTIN MILLS
Title or Position: PRESIDENT
Credential: MD
Phone: 310-550-1010