Healthcare Provider Details

I. General information

NPI: 1891652103
Provider Name (Legal Business Name): MILK WISE MEDICAL, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1848 COMMERCIAL ST
SAN DIEGO CA
92113-1037
US

IV. Provider business mailing address

1848 COMMERCIAL ST
SAN DIEGO CA
92113-1037
US

V. Phone/Fax

Practice location:
  • Phone: 858-204-7349
  • Fax:
Mailing address:
  • Phone: 818-216-2319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAJY ABULHOSN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 858-204-7349