Provider Demographics
NPI:1376611319
Name:MILLER, TONYA (RDMS)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16565 CERULEAN CT
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-4691
Mailing Address - Country:US
Mailing Address - Phone:714-401-9138
Mailing Address - Fax:
Practice Address - Street 1:16565 CERULEAN CT
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-4691
Practice Address - Country:US
Practice Address - Phone:714-401-9138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA428232471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography