Miller, Beverly Bushwick

Miller, Beverly Bushwick is an individual health care provider with primary practice located at 30030 Town Center Dr , Laguna Niguel CA 92677-2046. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Miller, Beverly Bushwick can be contacted via phone (949) 495-3031.

Contact Information

Primary practice address
30030 Town Center Dr Laguna Niguel CA 92677-2046
Phone: (949) 495-3031
Fax: (949) 495-9238
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X TA 0681 Maryland
Eye and Vision Services Providers / Optometrist 152W00000X 12963TPA California
Eye and Vision Services Providers / Optometrist 152W00000X OPC1430 Florida

Profile Details

NPI number 1588636856
LBN Legal business name Miller, Beverly Bushwick
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2006
Last updated Aug 8th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588636856 NPPES
Maryland Other 907716 BLOCK VISION
Maryland Other 1223367 BLOCK VISION
Maryland Other 271019 BLOCK VISION
Maryland Other OP2260 BLOCK VISION
Maryland Other 89160001 BLOCK VISION
Maryland Other 1032476 BLOCK VISION
Maryland MEDICAID 490518100 BLOCK VISION
Maryland Other 00X237 BLOCK VISION
Maryland Other 20-8901521 BLOCK VISION

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