Individual provider Active NPI

Ernesto Reyes Millan, MD

  • Pediatrics Physician
  • Rancho Mirage, CA
National Provider Identifier
1063595460
Registry record updated Jan 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G76678 Issued in CA
Practice address
39000 Bob Hope Dr
Ste K 211
Rancho Mirage, CA 92270
Phone
(760) 776-5620
Fax
(760) 776-5626
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G76678 CA Primary
Nurse Practitioner 363L00000X N406778 CA

Addresses

Primary practice location

39000 Bob Hope Dr
Ste K 211
Rancho Mirage, CA 92270

Mailing address

39000 Bob Hope Dr
Ste K 211
Rancho Mirage, CA 92270
Phone (760) 776-5620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G76678CAMDPediatrics Physician
N406778CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Unique Pediatric Medical Center Inc. Pediatrics PastSince Sep 15, 2019 Accepting new patients
Eisenhower Medical Center Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357862400000",
    "number": "1063595460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "address_2": "STE K 211",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "92270",
            "telephone_number": "760-776-5620",
            "fax_number": "760-776-5626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "address_2": "STE K 211",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "92270",
            "telephone_number": "760-776-5620",
            "fax_number": "760-776-5626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLAN",
        "first_name": "ERNESTO",
        "middle_name": "REYES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G76678",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "N406778",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.