MEDICARE: ANTHONY MARTIN MILLS M D A MEDICAL CORPORATION

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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1952076630
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTHONY MARTIN MILLS M D A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	8601 S BROADWAY
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90003-3319
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8601 S BROADWAY
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90003-3319
Country	:	US
Telephone Number	:	323-905-5675
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ANTHONY MARTIN MILLS
Credential	:
Telephone Number	:	310-550-1010

Provider Enumeration Date	:	08/13/2021
Last Update Date	:	04/09/2025

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