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NPI Code Detail

MEDICARE: SAMUEL MURILLO CADC A063110823

MEDICARE: SAMUEL MURILLO CADC A063110823
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2101YA0400XAddiction (Substance Use Disorder) Counselor
3175T00000XPeer Specialist

General Provider Information

NPI Number : 1023584737
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL MURILLO CADC A063110823
Provider Business Mailing Address
First Line : 44199 MONROE ST
Second Line :
City : INDIO
State : CA
Zip : 92201-3096
Country : US
Telephone Number : 951-602-3424
Fax Number :
Provider Business Practice Location Address
First Line : 44199 MONROE ST
Second Line :
City : INDIO
State : CA
Zip : 92201-3096
Country : US
Telephone Number : 951-602-3424
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2018
Last Update Date : 02/03/2026

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