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General NPI Number Information
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NPI Number | 1003008103
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Entity Type | Organization
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Legal Business Name | H MILANO MELLON MD INC
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 03/27/2013
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Provider Practice Location Address
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Address Line | 915 MYRTLE AVE
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City | INGLEWOOD
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State | CA
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Zip | 90301-4007
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Country | US
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Telephone | 310-673-3133
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Fax | 310-673-4277
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Provider Business Mailing Address
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Address Line | 915 MYRTLE AVE
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City | INGLEWOOD
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State | CA
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Zip | 90301-4007
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Country | US
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Telephone | 310-673-3133
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Fax | 310-673-4277
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Authorized Official
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Title or Position | OWNER
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Name | DR. H MILANO MELLON
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Credential | MD
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Telephone | 310-673-3133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | A30748
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License Number State | CA
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