Healthcare Provider Details

I. General information

NPI: 1548711096
Provider Name (Legal Business Name): MILANES MD MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2016
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26800 CROWN VALLEY PKWY STE 475
MISSION VIEJO CA
92691-8027
US

IV. Provider business mailing address

26800 CROWN VALLEY PKWY STE 475
MISSION VIEJO CA
92691-8027
US

V. Phone/Fax

Practice location:
  • Phone: 949-522-5081
  • Fax:
Mailing address:
  • Phone: 949-522-5081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA129904
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT MILANES
Title or Position: MD/PRESIDENT
Credential: M.D.
Phone: 949-522-5081