Provider Demographics
NPI:1629002902
Name:MILLARD, ARIEL SHOSHONA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARIEL
Middle Name:SHOSHONA
Last Name:MILLARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6191 N FRESNO ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8612
Mailing Address - Country:US
Mailing Address - Phone:559-432-3434
Mailing Address - Fax:
Practice Address - Street 1:6191 N FRESNO ST
Practice Address - Street 2:SUITE 102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8612
Practice Address - Country:US
Practice Address - Phone:559-432-3434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81866208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery