Provider Demographics
NPI:1215015037
Name:MILLS, PAUL JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JOSEPH
Last Name:MILLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 WOODSIDE RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-3499
Mailing Address - Country:US
Mailing Address - Phone:650-321-7303
Mailing Address - Fax:650-995-7714
Practice Address - Street 1:1733 WOODSIDE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94061-3499
Practice Address - Country:US
Practice Address - Phone:650-321-7303
Practice Address - Fax:650-995-7714
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG49542174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G49542Medicare ID - Type Unspecified
CAA51396Medicare UPIN