Provider Demographics
NPI:1841367893
Name:MCMILLIN, BRENDA J (DC)
Entity type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:J
Last Name:MCMILLIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:BRENDA
Other - Middle Name:J
Other - Last Name:MCMILLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:5911 HEIL AVE
Mailing Address - Street 2:STE F
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-3752
Mailing Address - Country:US
Mailing Address - Phone:714-840-6881
Mailing Address - Fax:714-840-6881
Practice Address - Street 1:5911 HEIL AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-3752
Practice Address - Country:US
Practice Address - Phone:714-377-2255
Practice Address - Fax:714-377-2256
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19547111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC19547Medicare ID - Type Unspecified