# HILLSIDE MOBILE PRIMARY CARE, A PROFESSIONAL NURSING CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154259729
- **Authorized official:** CARLY ANN MILLAN NP (CEO)
- **Authorized official phone:** (951) 889-5088

## Contact information

- **Practice address:** 12 S SAN GORGONIO AVE STE 202, BANNING, CA 92220-6015
- **Practice address phone:** (951) 889-5088
- **Mailing address:** 12 S SAN GORGONIO AVE STE 202, BANNING, CA 92220-6015

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 05/12/2026
- **Last updated:** 05/18/2026