Individual
DR. DANIEL JOSEPH MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4852 E BASELINE RD, #C-107, MESA, AZ 85206-4627
(480) 834-7000
(480) 834-7002
Mailing address
4852 E BASELINE RD, STE 107, MESA, AZ 85206-4628
(480) 834-7000
(480) 834-7002
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
30294
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3Z3972
HEALTHNET
AZ
05
—
699522
—
AZ
Enumeration date
06/08/2006
Last updated
10/21/2016
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