Provider Demographics
NPI:1285739128
Name:MILLER, ANGELA ROSE (DO)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:ROSE
Last Name:MILLER
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:26671 ALISO CREEK RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-4809
Mailing Address - Country:US
Mailing Address - Phone:949-831-0300
Mailing Address - Fax:949-831-0339
Practice Address - Street 1:26671 ALISO CREEK RD
Practice Address - Street 2:SUITE 205
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-4809
Practice Address - Country:US
Practice Address - Phone:949-831-0300
Practice Address - Fax:949-831-0339
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A6576207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG30604Medicare UPIN