MEDICARE: LAWRENCE MILNE MD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician
2	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1578956207
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAWRENCE MILNE MD INC

Provider Business Mailing Address
First Line	:	7777 GREENBACK LN STE 103
Second Line	:
City	:	CITRUS HTS
State	:	CA
Zip	:	95610-5800
Country	:	US
Telephone Number	:	916-835-7777
Fax Number	:	916-560-3320

Provider Business Practice Location Address
First Line	:	7777 GREENBACK LN STE 103
Second Line	:
City	:	CITRUS HTS
State	:	CA
Zip	:	95610-5800
Country	:	US
Telephone Number	:	916-835-7777
Fax Number	:	888-420-0067

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LAWRENCE MILNE
Credential	:	MD
Telephone Number	:	916-835-7777

Provider Enumeration Date	:	03/04/2015
Last Update Date	:	12/05/2023

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