1407915226 NPI number — DAVID JOHN MILLS MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407915226 NPI number — DAVID JOHN MILLS MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

MILLS

Provider First Name:

DAVID

Provider Middle Name:

JOHN

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

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:

1407915226

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

10/04/2024

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

2830 PUESTA DEL SOL

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

SANTA BARBARA

Provider Business Mailing Address State Name:

CA

Provider Business Mailing Address Postal Code:

93105-3006

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

805-682-9666

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

2830 PUESTA DEL SOL

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

SANTA BARBARA

Provider Business Practice Location Address State Name:

CA

Provider Business Practice Location Address Postal Code:

93105

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

805-682-9666

Provider Business Practice Location Address Fax Number:

612-573-2274

Provider Enumeration Date:

12/07/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2085R0203X , with the licence number:  G77889 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 50296 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 1407915226 . This is a "AMERICA'S PPO" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 134996 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 1407915226 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 960371052306 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 03083CO . This is a "BLUE CROSS AND BLUE SHIELD OF MN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 612627100 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
• Identifier: 34954100 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
• Identifier: HP79266 . This is a "HEALTHPARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: P00473006 . This is a "RR MEDICARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 1407915226 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
• Identifier: 254738 . This is a "MIDLANDS CHOICE INC" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".