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General NPI Number Information
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NPI Number | 1548852890
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Entity Type | Individual
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Provider Name | JOSE JULIO MURILLO
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Gender | Male
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Dates
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Enumeration Date | 02/08/2021
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Last Update Date | 11/02/2023
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Provider Practice Location Address
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Address Line | 49211 GRAPEFRUIT BLVD STE 6
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City | COACHELLA
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State | CA
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Zip | 92236-1480
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Country | US
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Telephone | 442-275-5572
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Fax |
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Provider Business Mailing Address
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Address Line | 49211 GRAPEFRUIT BLVD STE 5
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City | COACHELLA
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State | CA
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Zip | 92236-1480
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Country | US
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Telephone |
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | MPSS-YJIPWN
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License Number State | CA
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