Provider Demographics
NPI:1053713552
Name:PHILIP R. MILL, OD AND MICHAEL D. SUTTON, OD INC.
Entity type:Organization
Organization Name:PHILIP R. MILL, OD AND MICHAEL D. SUTTON, OD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:925-432-6484
Mailing Address - Street 1:3715 RAILROAD AVE STE C
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-5236
Mailing Address - Country:US
Mailing Address - Phone:925-432-6484
Mailing Address - Fax:925-432-3878
Practice Address - Street 1:3715 RAILROAD AVE STE C
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-5236
Practice Address - Country:US
Practice Address - Phone:925-432-6484
Practice Address - Fax:925-432-3878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13917 TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty