Healthcare Provider Details

I. General information

NPI: 1659559516
Provider Name (Legal Business Name): ERIC ANTON MULLER II M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2008
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3505 BROADWAY FL 10
OAKLAND CA
94611-5714
US

IV. Provider business mailing address

3505 BROADWAY FL 10
OAKLAND CA
94611-5714
US

V. Phone/Fax

Practice location:
  • Phone: 510-752-6298
  • Fax: 510-752-6754
Mailing address:
  • Phone: 510-752-6298
  • Fax: 510-752-6754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License NumberA106489
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: