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General NPI Number Information
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NPI Number | 1972895928
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Entity Type | Individual
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Provider Name | ELISEO MILLS JR. MD
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Gender | Male
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 101 E BEVERLY BLVD SUITE 400
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City | MONTEBELLO
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State | CA
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Zip | 90640-4300
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Country | US
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Telephone | 323-722-2928
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Fax | 323-722-1894
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Provider Business Mailing Address
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Address Line | 101 E BEVERLY BLVD SUITE 400
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City | MONTEBELLO
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State | CA
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Zip | 90640-4300
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Country | US
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Telephone | 323-722-2928
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Fax | 323-722-1894
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A40310
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License Number State | CA
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