| Organization Name: | MILLS-PENINSULA MEDICAL GROUP |
| NPI Number: | 1639384274 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHARON KATZ (VP OF MEDICAL MANAGEMENT PRIVACY OF) |
| Mailing Address: | 577 Airport Blvd Suite 300 Burlingame |
| State: | CA US |
| Postal Code: | 940102020 |
| Phone Number: | 6502408000 |
| Fax Number: | 6502400953 |
| NPI Enumeration Date: | 05/14/2007 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |