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John Dennis Mull

Family Medicine

Allopathic & Osteopathic Physicians

4425 South Central Ave, South Central Family Health Center, Los Angeles, CA 90011-3629

PECOS Enrollment

This provider is enrolled in PECOS as JOHN MULL.

Based on the most recent information from CMS, provider John Dennis Mull is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 15 days ago.

Profile Details

Provider ID
1962553651
Provider Type
Individual
Full Name
Mull, John Dennis
Title
Dr.
Credential
MD MPH

Gender
Male
Sole Proprietor
No
Enumeration Date
1/16/2007
Last Updated
7/8/2007

Contact Information

Practice Location

4425 South Central Ave, South Central Family Health Center, Los Angeles, CA 90011-3629

(323) 908-4219

(323) 908-4262

Mailing Location

6 Whitman Court, Irvine, CA 92617-4056

(949) 509-7507

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License G019001 California

John Dennis Mull

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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