Individual
TIMOTHY ROBERT MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 JOURNEY, SUITE 208, ALISO VIEJO, CA 92656-3332
(949) 215-5402
Mailing address
2 JOURNEY, SUITE 208, ALISO VIEJO, CA 92656-3332
(949) 215-5402
Taxonomy
Speciality
Code
Description
License number
State
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
Primary
A90958
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A909580
BLUE SHIELD
CA
01
—
A90958
LICENSE #
CA
Enumeration date
07/17/2006
Last updated
04/23/2014
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