| Millie Medical Of California Pc | |
|
111 N Market St Ste 379 San Jose CA 95113-1101 | |
| (669) 305-6600 | |
| Not Available |
| Full Name | Millie Medical Of California Pc |
|---|---|
| Speciality | General Practice |
| Location | 111 N Market St Ste 379, San Jose, California |
| Authorized Official Name and Position | Michael Hafran (OWNER) |
| Authorized Official Contact | 2628440695 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Millie Medical Of California Pc 548 Market St Ste 73799 San Francisco CA 94104-5401 Ph: (262) 844-0695 | Millie Medical Of California Pc 111 N Market St Ste 379 San Jose CA 95113-1101 Ph: (669) 305-6600 |
| NPI Number | 1740926534 |
|---|---|
| Provider Enumeration Date | 05/05/2022 |
| Last Update Date | 05/05/2022 |
| Medicare PECOS PAC ID | 8426438011 |
|---|---|
| Medicare Enrollment ID | O20220628003431 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740926534 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Michael J Hafran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003878000 PECOS PAC ID: 4183726375 Enrollment ID: I20220628003491 |
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