Provider Demographics
NPI:1700988219
Name:MCMILLAN, JAMES IRA (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:IRA
Last Name:MCMILLAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11201 BENTON ST
Mailing Address - Street 2:VA LOMA LINDA HEALTHCARE SYSTEM, NEPHROLOGY (111N)
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92357-1000
Mailing Address - Country:US
Mailing Address - Phone:909-583-6090
Mailing Address - Fax:909-777-3858
Practice Address - Street 1:11201 BENTON ST
Practice Address - Street 2:VA LOMA LINDA HEALTHCARE SYSTEM, NEPHROLOGY (111N)
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92357-1000
Practice Address - Country:US
Practice Address - Phone:909-583-6090
Practice Address - Fax:909-777-3858
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2014-11-05
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Provider Licenses
StateLicense IDTaxonomies
CAG61383207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine