Individual provider Active NPI

Van H Miller, MD

  • Emergency Medicine Physician
  • Lynwood, CA
National Provider Identifier
1336177203
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G37696 Issued in CA
Practice address
3630 East Imperial Highway
Lynwood, CA 90262-2678
Phone
(310) 900-8900
NPI assigned
Jun 29, 2006
Last updated
Dec 8, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G37696 CA Primary

Addresses

Primary practice location

3630 East Imperial Highway
Lynwood, CA 90262-2678

Mailing address

PO Box 12110
Westminster, CA 92685-2110
Phone (562) 809-3571

Other identifiers 1

IdentifierTypeStateIssuer
00G376960MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G37696CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Multispecialty Medical Group, Inc. Past Accepting new patients
St Francis Medical Center Past Accepting new patients
Front Line Emergency Care Spec Emergency Medicine Past Accepting new patients
St. Francis Multispecialty Medical Group, Inc. Past Accepting new patients
Cep America - California Emergency Medicine Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260230400000",
    "number": "1336177203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12110",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926852110",
            "telephone_number": "562-809-3571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 EAST IMPERIAL HIGHWAY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622678",
            "telephone_number": "310-900-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "VAN",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2009-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G37696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G376960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.