# MILLER COSMETICS INC. A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** OC Domer Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194150813
- **Authorized official:** TODD C MILLER M.D. (PRESIDENT)
- **Authorized official phone:** (909) 215-9463

## Contact information

- **Practice address:** 1501 SUPERIOR AVE, SUITE 301, NEWPORT BEACH, CA 92663-3600
- **Practice address phone:** (909) 215-9463
- **Mailing address:** 1501 SUPERIOR AVE, SUITE 301, NEWPORT BEACH, CA 92663-3600
- **Mailing address phone:** (909) 215-9463

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YS0123X | Facial Plastic Surgery Physician | A90116 | CA | — |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | A90116 | CO | Yes |

## Other

- **Enumeration date:** 09/12/2013
- **Last updated:** 09/12/2013