Provider Demographics
NPI:1578060174
Name:MUELLER, BRYAN AARON (MD)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:AARON
Last Name:MUELLER
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:NAVAL MEDICAL CENTER SAN DIEGO 38400 BOB WILSON DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-5000
Mailing Address - Country:US
Mailing Address - Phone:619-379-8607
Mailing Address - Fax:
Practice Address - Street 1:NAVAL BRANCH HEALTH CLINIC PORT HUENEME
Practice Address - Street 2:162 FIRST STREET, BLDG. 1402
Practice Address - City:PORT HUENEME
Practice Address - State:CA
Practice Address - Zip Code:93043
Practice Address - Country:US
Practice Address - Phone:805-982-2733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA163842208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program