Provider Demographics
NPI:1881638062
Name:MILLS, CATHERINE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MARIE
Last Name:MILLS
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 1:2125 OAK GROVE ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598
Mailing Address - Country:US
Mailing Address - Phone:925-296-7150
Mailing Address - Fax:925-296-7171
Practice Address - Street 1:2125 OAK GROVE ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598
Practice Address - Country:US
Practice Address - Phone:925-296-7150
Practice Address - Fax:925-296-7171
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG461172085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G461170Medicaid
CA300121746OtherRAILROAD MEDICARE
CA00G461175Medicare PIN
CAA50288Medicare UPIN
CA00G461170Medicaid
CA00G461173Medicare PIN