Timothy Robert Miller, M.D.

Primary specialty

Plastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianTaxonomy code 2082S0099X

License

A90958 Issued in CA

Practice address

2 Journey
Suite 208
Aliso Viejo, CA 92656-3332

Phone

(949) 215-5402

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Richard a. Gangnes M.D. Inc.

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • San Clemente, CA
  • NPI 1568495562
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1992723209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 JOURNEY",
            "address_2": "SUITE 208",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563332",
            "telephone_number": "949-215-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 JOURNEY",
            "address_2": "SUITE 208",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563332",
            "telephone_number": "949-215-5402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "TIMOTHY",
        "middle_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "CA",
            "license": "A90958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A909580",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "A90958",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katy Lynn Metcalf, OTR/L
• Marie Miao, LCSW
• Melissa Mihalick
• Angela Rose Miller, D.O.
• Judith Ann Miller
• Desiree Ann Mills, FNP-C
• Evaggelos Gary Mitrevolis, MD
• Sonya Mitrovich, M.D.
• Saeideh Modjaby
• Ryann Monteiro

• Plastic Surgery Physician in Aliso Viejo, CA
• Providers in Aliso Viejo, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; 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.