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General NPI Number Information
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NPI Number | 1356535736
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Entity Type | Individual
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Provider Name | JONAH NATHANIEL MULLENS DPM
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Gender | Male
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 04/28/2024
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Provider Practice Location Address
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Address Line | 500 ARGUELLO STREET SUITE 100
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City | REDWOOD CITY
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State | CA
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Zip | 94063
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Country | US
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Telephone | 650-851-4900
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Fax | 650-995-1218
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Provider Business Mailing Address
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Address Line | 300 PASTEUR DR STE 100
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City | STANFORD
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State | CA
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Zip | 94305-2200
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Country | US
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Telephone | 650-723-4000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E4673
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 4673
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 4673
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License Number State | CA
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