Healthcare Provider Details

I. General information

NPI: 1992897292
Provider Name (Legal Business Name): CHRISTOPHER MILLS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 05/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20044 CEDAR RD N SUITE A
SONORA CA
95370-5900
US

IV. Provider business mailing address

14542 LOLLY LN
SONORA CA
95370-9226
US

V. Phone/Fax

Practice location:
  • Phone: 209-536-3750
  • Fax: 209-532-9811
Mailing address:
  • Phone: 209-536-3996
  • Fax: 209-533-7696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA24522
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: