Provider Demographics
NPI:1073860896
Name:DR LAYN MILLER DC APCC
Entity Type:Organization
Organization Name:DR LAYN MILLER DC APCC
Other - Org Name:THE HEAD, NECK BACK PAIN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LAYN
Authorized Official - Middle Name:FORD
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-965-9999
Mailing Address - Street 1:10810 WARNER AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-3848
Mailing Address - Country:US
Mailing Address - Phone:714-965-9999
Mailing Address - Fax:
Practice Address - Street 1:10810 WARNER AVE STE 5
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-3848
Practice Address - Country:US
Practice Address - Phone:714-965-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC022835261Q00000X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU71520Medicare UPIN