Individual
MARK P MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1211 W LA PALMA AVE, SUITE 101, ANAHEIM, CA 92801-2815
(714) 635-9680
(714) 635-2924
Mailing address
1211 W LA PALMA AVE, SUITE 101, ANAHEIM, CA 92801-2815
(714) 635-9680
(714) 635-2924
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
G28208
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G282080
—
CA
01
—
ZZZ098672
BLUE SHIELD OF CALIF
CA
Enumeration date
04/04/2006
Last updated
07/09/2009
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