Healthcare Provider Details

I. General information

NPI: 1033258991
Provider Name (Legal Business Name): MR. CHRISTOPHER O MILLS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 12/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 JEFFERSON AVE. 202
REDWOOD CITY CA
94063
US

IV. Provider business mailing address

31770 ALVARADO BLVD #180
UNION CITY CA
94587-3951
US

V. Phone/Fax

Practice location:
  • Phone: 650-871-9070
  • Fax:
Mailing address:
  • Phone: 650-817-9070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: