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Individual

DR. BEVERLY BUSHWICK MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
30030 TOWN CENTER DR, LAGUNA NIGUEL, CA 92677-2046
(949) 495-3031
(949) 495-9238
Mailing address
30030 TOWN CENTER DR, LAGUNA NIGUEL, CA 92677-2046
(949) 495-3031
(949) 495-9238

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12963TPA
CA
152W00000X
Optometrist
OPC1430
FL
152W00000X
Optometrist
TA 0681
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00X237
CAREFIRST BC/BS
MD
01
1032476
AETNA
MD
01
1223367
CAQH
MD
01
20-8901521
HEALTHNET/TRICARE
MD
01
271019
MDIPA/MAMSI
MD
05
490518100
MD
01
89160001
BLUECROSS
DC
01
907716
BLOCK VISION
MD
01
OP2260
EYEMED
MD
Enumeration date
02/02/2006
Last updated
08/08/2013
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