Healthcare Provider Details

I. General information

NPI: 1922066372
Provider Name (Legal Business Name): RAYMOND F MULLER L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 BROADWAY SUITE 5
MILLBRAE CA
94030-1336
US

IV. Provider business mailing address

1301 BROADWAY SUITE 5
MILLBRAE CA
94030-1336
US

V. Phone/Fax

Practice location:
  • Phone: 650-872-2287
  • Fax: 650-872-2286
Mailing address:
  • Phone: 650-872-2287
  • Fax: 650-872-2286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC3102
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: