Individual provider Active NPI

John Robert Mills, M.D.

  • Pediatrics Physician
  • Daly City, CA
National Provider Identifier
1679624449
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G76506 Issued in CA
Practice address
1900 Sullivan Ave
Daly City, CA 94015
Phone
(650) 315-7928
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G76506 CA Primary

Addresses

Primary practice location

1900 Sullivan Ave
Daly City, CA 94015

Mailing address

705 Noe St
San Francisco, CA 94114-2922
Phone (650) 315-7928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190308000692 HI Practitioner - Pediatric MedicinePractitioner - Other (Physician) 7517130099 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G76506CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kapiolani Medical Specialists CurrentSince Oct 7, 2019 Accepting new patients
Hawaii Permanente Medical Group Inc CurrentSince Feb 4, 2019 Accepting new patients

Locations

1319 Punahou St
Honolulu, HI 96826
Phone (808) 485-4300

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679624449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 NOE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941142922",
            "telephone_number": "650-315-7928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SULLIVAN AVE",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "94015",
            "telephone_number": "650-315-7928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G76506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

Verify at the official NPI Registry.