Healthcare Provider Details

I. General information

NPI: 1578956207
Provider Name (Legal Business Name): LAWRENCE MILNE MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2015
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 GREENBACK LN STE 103
CITRUS HTS CA
95610-5800
US

IV. Provider business mailing address

7777 GREENBACK LN STE 103
CITRUS HTS CA
95610-5800
US

V. Phone/Fax

Practice location:
  • Phone: 916-835-7777
  • Fax: 888-420-0067
Mailing address:
  • Phone: 916-835-7777
  • Fax: 916-560-3320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LAWRENCE MILNE
Title or Position: PRESIDENT
Credential: MD
Phone: 916-835-7777