Provider Demographics
NPI:1992897292
Name:MILLS, CHRISTOPHER (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:MILLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14542 LOLLY LN
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-9226
Mailing Address - Country:US
Mailing Address - Phone:209-536-3996
Mailing Address - Fax:209-533-7696
Practice Address - Street 1:20044 CEDAR RD N
Practice Address - Street 2:SUITE A
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5900
Practice Address - Country:US
Practice Address - Phone:209-536-3750
Practice Address - Fax:209-532-9811
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24522207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A245223Medicare PIN
CAA24014Medicare UPIN