Individual
CARL LYON MILLWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
222 W 39TH AVE, SAN MATEO, CA 94403-4364
(650) 573-2222
Mailing address
141 CRESCENT AVE, BURLINGAME, CA 94010-5246
(650) 573-2222
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A55816
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A558160
—
CA
Enumeration date
02/12/2007
Last updated
07/08/2007
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