Provider Information for 1184222101
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RICHARD DOUG MILLS
Sex: Male
NPI: 1184222101
Last Updated: 2023-10-25
Certification Date: 2023-10-25
Certification Date: 2023-10-25
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1184222101 | ||||||||
| Enumeration Date | 2020-10-12 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 7100 SAN RAMON RD APT 129 DUBLIN, CA 94568-3230 United States Phone: 484-860-4701 | Fax: | ||||||||
| Primary Practice Address | 2001 THE ALAMEDA SAN JOSE, CA 95126-1136 United States Phone: 408-261-7777 | Fax:408-259-2273 | ||||||||
| Secondary Practice Address(es) | 307 2ND AVE | ||||||||
| Health Information Exchange |
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