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NPI Code Detail

MEDICARE: LOTUS MILLER

MEDICARE: LOTUS MILLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1154254894
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOTUS MILLER
Provider Business Mailing Address
First Line : 1255 E 66TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90001-1622
Country : US
Telephone Number : 323-810-4976
Fax Number :
Provider Business Practice Location Address
First Line : 100 WASHINGTON AVE S STE 1210
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55401-2511
Country : US
Telephone Number : 866-492-5336
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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Directions to “ LOTUS MILLER ” Practice Location

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