Provider Demographics
NPI:1558495960
Name:MIGLER, ANTHONY W (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:W
Last Name:MIGLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6459
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93006-6459
Mailing Address - Country:US
Mailing Address - Phone:805-978-5809
Mailing Address - Fax:805-978-5782
Practice Address - Street 1:1600 N ROSE AVE
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-3722
Practice Address - Country:US
Practice Address - Phone:805-988-2708
Practice Address - Fax:805-981-4423
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG38626207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1376601393OtherGROUP NPI
CAG38626OtherMEDICAL BOARD OF CA
CAGR0059650Medicaid
CA00G386260Medicaid
CA220012460OtherRAILROAD MEDICARE
CAGR0059650Medicaid
CA00G386260Medicaid
CAHW8241Medicare PIN
CAWG38626BMedicare PIN