Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | A62503 | CA |
N | 207VX0000X | Obstetrician | A62503 | CA |
NPI | 1255345203 |
---|---|
Provider Name | Patrick Michael Mullin |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Mission Hills, CA 91345-1252 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 29/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G99547 | (02) | CA |