1194724492 NPI number — FRANKLIN G MILLIN MD

Table of content: FRANKLIN G MILLIN MD (NPI 1194724492)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194724492 NPI number — FRANKLIN G MILLIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLIN
Provider First Name:
FRANKLIN
Provider Middle Name:
G
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194724492
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/30/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
625 FAIR OAKS AVE STE 270
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH PASADENA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91030-5801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-346-2455
Provider Business Mailing Address Fax Number:
626-639-3005

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1900 ATLANTIC AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90806-5502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-437-0373
Provider Business Practice Location Address Fax Number:
877-469-3631
Provider Enumeration Date:
07/19/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0300X , with the licence number:  G48663 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: G48663 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P01485584 . This is a "RAILROAD MEDICARE-DV5277" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: P01486716 . This is a "RAILROAD MEDICARE-DU4034" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: EFFECTIVE 5/1/1984 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00G486630 . This is a "MEDI CAL #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: P01486725 . This is a "RAILROAD MEDICARE-DU4032" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: P01485584 . This is a "RAILROAD MEDICARE-DU5182" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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