MEDICARE: MILLS PENINSULA EMERGENCY MEDICAL ASSOCIATES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841226529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILLS PENINSULA EMERGENCY MEDICAL ASSOCIATES INC

Provider Business Mailing Address
First Line	:	PO BOX 920130
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75392-0130
Country	:	US
Telephone Number	:	877-346-2211
Fax Number	:	626-447-6057

Provider Business Practice Location Address
First Line	:	1501 TROUSDALE DR
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-4506
Country	:	US
Telephone Number	:	650-696-5500
Fax Number	:	650-696-5378

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ALLAN J BRODY
Credential	:	M.D.
Telephone Number	:	650-245-7240

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	01/23/2026

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