# MARK MILLER MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558656090
- **Authorized official:** MR. MARK EDMUND MILLER II MD (CEO)
- **Authorized official phone:** (626) 405-1513

## Contact information

- **Practice address:** 800 FAIRMOUNT AVE, STE 205, PASADENA, CA 91105-3150
- **Practice address phone:** (626) 405-1513
- **Practice address fax:** (626) 449-1166
- **Mailing address:** 510 W CENTRAL AVE, STE A, BREA, CA 92821-3032
- **Mailing address phone:** (714) 996-1633
- **Mailing address fax:** (714) 996-9267

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | A76869 | CA | Yes |

## Other

- **Enumeration date:** 06/13/2011
- **Last updated:** 06/13/2011