Individual
DAN MIULLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
400 N PEPPER AVE, DEPT. SURGERY MODULAR # 3, COLTON, CA 92324-1801
(909) 580-3353
(909) 580-1363
Mailing address
PO BOX 670, REDLANDS, CA 92373
(909) 580-3353
(909) 580-1363
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
020A81530
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0079700
—
CA
01
—
ZZZ13858Z
MEDICARE GROUP NUMBER
CA
Enumeration date
08/25/2006
Last updated
07/16/2010
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