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General NPI Number Information
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NPI Number | 1609861079
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Entity Type | Individual
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Provider Name | KIMIKO P MILLER PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 300 E YORBA LINDA BLVD STE B
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City | PLACENTIA
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State | CA
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Zip | 92870-2910
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Country | US
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Telephone | 714-524-6000
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Fax | 714-524-6007
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Provider Business Mailing Address
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Address Line | 2722 SNOWFIELD ST
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City | BREA
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State | CA
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Zip | 92821-4662
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Country | US
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Telephone | 714-743-2722
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Fax | 714-524-6007
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA-11833
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA11833
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA11833
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License Number State | CA
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