Miller, Beverly Bushwick
Miller, Beverly Bushwick is an individual health care provider with primary practice located at 30030 Town Center Dr , Laguna Niguel CA 92677-2046. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Miller, Beverly Bushwick can be contacted via phone (949) 495-3031.Contact Information
Primary practice address
30030 Town Center Dr
Laguna Niguel CA 92677-2046
Phone: (949) 495-3031
Fax: (949) 495-9238
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | TA 0681 | Maryland |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 12963TPA | California |
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPC1430 | Florida |
Profile Details
| NPI number | 1588636856 |
|---|---|
| LBN Legal business name | Miller, Beverly Bushwick |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 2nd, 2006 |
| Last updated | Aug 8th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588636856 | NPPES |
| Maryland | Other | 907716 | BLOCK VISION |
| Maryland | Other | 1223367 | BLOCK VISION |
| Maryland | Other | 271019 | BLOCK VISION |
| Maryland | Other | OP2260 | BLOCK VISION |
| Maryland | Other | 89160001 | BLOCK VISION |
| Maryland | Other | 1032476 | BLOCK VISION |
| Maryland | MEDICAID | 490518100 | BLOCK VISION |
| Maryland | Other | 00X237 | BLOCK VISION |
| Maryland | Other | 20-8901521 | BLOCK VISION |
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