S Michael Millbern MD Medical Corporation

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

C36162 Issued in CA

Legal business name

S MICHAEL MILLBERN MD MEDICAL CORPORATION

Practice address

8929 University Center LN Ste 103
San Diego, CA 92122-1007

Phone

(858) 554-0220

Fax

(858) 554-0458

NPI assigned

Apr 20, 2018

Organization subpart

No

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

Authorized official

Name

Dr. S Michael Millbern, MD

Title

President

Phone

(714) 347-1000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524182400000",
    "number": "1720575103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "714-347-1000",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8929 UNIVERSITY CENTER LN STE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221007",
            "telephone_number": "858-554-0220",
            "fax_number": "858-554-0458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S MICHAEL MILLBERN MD MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-20",
        "last_updated": "2018-04-20",
        "status": "A",
        "authorized_official_last_name": "MILLBERN",
        "authorized_official_first_name": "S",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-347-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "C36162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; 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.