Healthcare Provider Details

I. General information

NPI: 1720344013
Provider Name (Legal Business Name): DEBBIE Y. MILMAN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 11/30/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 ZONAL AVE
LOS ANGELES CA
90089-0121
US

IV. Provider business mailing address

1550 TOWN CENTER DR
MONTEBELLO CA
90640-2173
US

V. Phone/Fax

Practice location:
  • Phone: 323-226-5700
  • Fax:
Mailing address:
  • Phone: 323-724-7159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20A11987
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: