Provider Demographics
NPI:1407214612
Name:MULDER, GEORGE ARNOLD (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:ARNOLD
Last Name:MULDER
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 1:1150 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-2329
Mailing Address - Country:US
Mailing Address - Phone:626-796-0842
Mailing Address - Fax:
Practice Address - Street 1:1150 LAUREL ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-2329
Practice Address - Country:US
Practice Address - Phone:626-796-0842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG10772208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)