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NPI Code Detail

MEDICARE: MR. BENJAMIN MILLER MS

MEDICARE: MR. BENJAMIN MILLER MS
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1497461404
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BENJAMIN MILLER MS
Provider Business Mailing Address
First Line : 112 N HIGHLAND AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90036-3031
Country : US
Telephone Number : 310-422-5216
Fax Number :
Provider Business Practice Location Address
First Line : 112 N HIGHLAND AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90036-3031
Country : US
Telephone Number : 310-422-5216
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2023
Last Update Date : 04/06/2025

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