Healthcare Provider Details

I. General information

NPI: 1902825540
Provider Name (Legal Business Name): FRANCIS LAURENCE MUELLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 03/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3883 AIRWAY DR SUITE 220
SANTA ROSA CA
95403-1670
US

IV. Provider business mailing address

3883 AIRWAY DR SUITE 220
SANTA ROSA CA
95403-1670
US

V. Phone/Fax

Practice location:
  • Phone: 707-521-7750
  • Fax: 707-521-7745
Mailing address:
  • Phone: 707-521-7750
  • Fax: 707-521-7745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG30399
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberG30399
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: