Individual
JEFFREY A MULLVAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4060 FOURTH AVENUE, SUITE 500, SAN DIEGO, CA 92103-2120
(619) 260-1900
(619) 260-1919
Mailing address
4060 FOURTH AVE, #500, SAN DIEGO, CA 92103-2120
(619) 260-1900
(619) 260-1919
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G57253
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G57253
—
CA
Enumeration date
09/14/2006
Last updated
06/20/2022
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