Organization
MILL MEDICAL CLINIC INC
Active
Other names
Mill Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL C KINTANAR (OFFICE MANAGER)
(909) 253-0841
Entity
Organization
Contact information
Practice address
1292 W MILL ST, SUITE 105, SAN BERNARDINO, CA 92410-2500
(909) 383-9440
(909) 383-9443
Mailing address
1292 W MILL ST, SUITE 105, SAN BERNARDINO, CA 92410-2500
(909) 253-0841
(909) 521-7154
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A383760
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A383760
—
CA
05
—
00A383761
—
CA
05
—
GR0078010
—
CA
Enumeration date
10/09/2006
Last updated
08/21/2014
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