Organization
JEFFRY A MULLVAIN MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFRY A MULLVAIN MD (PHYSICIAN/PRESIDENT)
(619) 260-1900
Entity
Organization
Contact information
Practice address
4060 FOURTH AVE, SUITE 500, SAN DIEGO, CA 92103-2116
(619) 260-1900
(619) 260-1919
Mailing address
4060 FOURTH AVE, SUITE 500, SAN DIEGO, CA 92103-2116
(619) 260-1900
(619) 260-1900
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G57253
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G572530
—
CA
Enumeration date
08/03/2010
Last updated
08/03/2010
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