Healthcare Provider Details

I. General information

NPI: 1891881520
Provider Name (Legal Business Name): FLOYD EUGENE MILNER M.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 09/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 BROCKTON AVE STE 210
RIVERSIDE CA
92501-4026
US

IV. Provider business mailing address

18841 SUMMERLEAF LN
RIVERSIDE CA
92504-9416
US

V. Phone/Fax

Practice location:
  • Phone: 951-778-0181
  • Fax: 951-779-9818
Mailing address:
  • Phone: 951-778-0181
  • Fax: 951-779-9818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU592
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberHA1359
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: