Provider Demographics
NPI:1013799808
Name:MULLIGAN, EMIEL MURPHY
Entity Type:Individual
Prefix:
First Name:EMIEL
Middle Name:MURPHY
Last Name:MULLIGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58923 BUS CENTER DR SUITE A-E
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284
Mailing Address - Country:US
Mailing Address - Phone:760-365-7209
Mailing Address - Fax:760-255-7280
Practice Address - Street 1:58923 BUS CENTER DR SUITE A-E
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284
Practice Address - Country:US
Practice Address - Phone:760-365-7209
Practice Address - Fax:760-255-7280
Is Sole Proprietor?:No
Enumeration Date:2023-10-17
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator