Provider Demographics
NPI:1457199572
Name:KIMIKO MILLER, PHYSICIAN ASSISTANT,INC
Entity type:Organization
Organization Name:KIMIKO MILLER, PHYSICIAN ASSISTANT,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIMIKO
Authorized Official - Middle Name:P
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:714-743-2722
Mailing Address - Street 1:2722 SNOWFIELD ST
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-4662
Mailing Address - Country:US
Mailing Address - Phone:714-743-2722
Mailing Address - Fax:714-524-6007
Practice Address - Street 1:300 E YORBA LINDA BLVD STE B
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-2910
Practice Address - Country:US
Practice Address - Phone:714-524-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KIMIKO MILLER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-15
Last Update Date:2025-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center