Provider Demographics
NPI:1710321138
Name:MULLIGAN, PATRICK R (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:R
Last Name:MULLIGAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 6102
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94948-6102
Mailing Address - Country:US
Mailing Address - Phone:415-884-3404
Mailing Address - Fax:415-883-0877
Practice Address - Street 1:100 S SAN MATEO DR
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-3805
Practice Address - Country:US
Practice Address - Phone:650-696-4515
Practice Address - Fax:650-696-4626
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2023-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA1344612085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology