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General NPI Number Information
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NPI Number | 1497928220
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Entity Type | Organization
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Legal Business Name | MILLS PARK MEDICAL CENTER, INC
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Dates
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Enumeration Date | 04/13/2008
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Last Update Date | 04/13/2008
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Provider Practice Location Address
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Address Line | 2828 MILLS PARK DR SUITE B
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670-4711
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Country | US
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Telephone | 916-363-8888
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Fax | 916-368-0105
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Provider Business Mailing Address
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Address Line | 2828 MILLS PARK DR SUITE B
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670-4711
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Country | US
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Telephone | 916-363-8888
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Fax | 916-368-0105
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Authorized Official
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Title or Position | MANAGER
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Name | RENA XIAN
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Credential |
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Telephone | 916-363-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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