=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144681768
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MILTON H. LOUIE, MD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/09/2016
-----------------------------------------------------
Last Update Date | 03/09/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1041 BRADFORD CT
-----------------------------------------------------
City | PLEASANTON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94566-4507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-425-7245
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1041 BRADFORD CT
-----------------------------------------------------
City | PLEASANTON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94566-4507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-425-7245
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | MILTON H LOUIE
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 925-425-7245
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number | G33478
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------