Provider Demographics
NPI:1700809431
Name:MILLS, DON FREDRIC (MD)
Entity type:Individual
Prefix:DR
First Name:DON
Middle Name:FREDRIC
Last Name:MILLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1809
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92856-0809
Mailing Address - Country:US
Mailing Address - Phone:714-619-5387
Mailing Address - Fax:770-701-6662
Practice Address - Street 1:17 CORPORATE PLAZA DR
Practice Address - Street 2:#120
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7902
Practice Address - Country:US
Practice Address - Phone:949-706-6300
Practice Address - Fax:949-706-6301
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG54273207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G542730OtherBLUE SHIELD
CA00G542730Medicare PIN
F23139Medicare UPIN
CA00G542730OtherBLUE SHIELD
CAG54273BMedicare PIN