Provider Demographics
NPI:1225101355
Name:MILLEN, MARLENE MAY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARLENE
Middle Name:MAY
Last Name:MILLEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:200 W ARBOR DR DEPT 8201
Mailing Address - Street 2:UCSD MEDICAL CENTER
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-8201
Mailing Address - Country:US
Mailing Address - Phone:619-471-9250
Mailing Address - Fax:619-543-3183
Practice Address - Street 1:200 W ARBOR DR DEPT 8201
Practice Address - Street 2:UCSD MEDICAL CENTER
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-8201
Practice Address - Country:US
Practice Address - Phone:619-471-9250
Practice Address - Fax:619-543-3183
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA82259207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A825590Medicaid
CAWA68784AMedicare ID - Type Unspecified
CA00A825590Medicaid