Provider Demographics
NPI:1104442011
Name:MACMILLAN, SARAH ELISABETH (DPT)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ELISABETH
Last Name:MACMILLAN
Suffix:
Gender:F
Credentials:DPT
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Mailing Address - Street 1:23521 PASEO DE VALENCIA
Mailing Address - Street 2:SUITE B7
Mailing Address - City:LAGUNA BILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3014
Mailing Address - Country:US
Mailing Address - Phone:949-597-0007
Mailing Address - Fax:949-597-0040
Practice Address - Street 1:30100 TOWNE CENTER DRIVE
Practice Address - Street 2:SUITE YZ
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-2064
Practice Address - Country:US
Practice Address - Phone:949-597-0007
Practice Address - Fax:949-597-0040
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT297968225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist