Provider Demographics
NPI:1336173822
Name:MULLER, JULIA GRAVES (MD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:GRAVES
Last Name:MULLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:GRAVES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3300 WEBSTER ST STE 509
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3149
Mailing Address - Country:US
Mailing Address - Phone:510-452-0330
Mailing Address - Fax:510-275-0851
Practice Address - Street 1:3300 WEBSTER ST STE 509
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3149
Practice Address - Country:US
Practice Address - Phone:510-452-0060
Practice Address - Fax:510-452-2152
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004019683207N00000X
CAA107396207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CC202AMedicare PIN