Provider Demographics
NPI:1346231552
Name:CALDWELL-MILLER, MIKAL MARIE (MA, F-AAA)
Entity Type:Individual
Prefix:MRS
First Name:MIKAL
Middle Name:MARIE
Last Name:CALDWELL-MILLER
Suffix:
Gender:F
Credentials:MA, F-AAA
Other - Prefix:MRS
Other - First Name:MIKAL
Other - Middle Name:MARIE
Other - Last Name:CALDWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7851 WALKER ST
Mailing Address - Street 2:SUITE #206
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-1747
Mailing Address - Country:US
Mailing Address - Phone:714-523-4327
Mailing Address - Fax:714-523-4313
Practice Address - Street 1:7851 WALKER ST
Practice Address - Street 2:SUITE #206
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-1747
Practice Address - Country:US
Practice Address - Phone:714-523-4327
Practice Address - Fax:714-523-4313
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2241237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWAU2190Medicare ID - Type Unspecified# FROM PREVIOUS EMP/ADDR
CAAU2241Medicare ID - Type Unspecified