Healthcare Provider Details

I. General information

NPI: 1114998549
Provider Name (Legal Business Name): KAREN L MILMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 05/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CROWN POINT CIR 110
GRASS VALLEY CA
95945-9514
US

IV. Provider business mailing address

500 CROWN POINT CIR 110
GRASS VALLEY CA
95945-9514
US

V. Phone/Fax

Practice location:
  • Phone: 530-265-1459
  • Fax: 530-265-0894
Mailing address:
  • Phone: 530-265-1459
  • Fax: 530-271-0894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2005019380
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberA107368
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberD0064958
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: