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General NPI Number Information
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NPI Number | 1598872004
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Entity Type | Organization
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Legal Business Name | MILLS-PENINSULA HEALTH SERVICES
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 04/28/2016
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Provider Practice Location Address
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Address Line | 1501 TROUSDALE DR
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City | BURLINGAME
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State | CA
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Zip | 94010-4506
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Country | US
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Telephone | 650-696-5400
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Fax | 650-652-3052
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Provider Business Mailing Address
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Address Line | PO BOX 60000 FILE #73688
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City | SAN FRANCISCO
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State | CA
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Zip | 94160-0001
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Country | US
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Telephone | 650-696-5400
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Fax | 650-652-3052
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Authorized Official
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Title or Position | CFO SHBA
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Name | JOHN GATES
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Credential |
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Telephone | 510-450-7357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number |
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License Number State |
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