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General NPI Number Information
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NPI Number | 1386032993
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Entity Type | Organization
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Legal Business Name | HEAD TO TOE LASER CENTERS
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Dates
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Enumeration Date | 01/05/2015
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Last Update Date | 01/05/2015
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Provider Practice Location Address
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Address Line | 3257 CAMINO DE LOS COCHES #203
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City | CARLSBAD
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State | CA
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Zip | 92009-8976
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Country | US
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Telephone | 760-944-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 3257 CAMINO DE LOS COCHES #203
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City | CARLSBAD
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State | CA
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Zip | 92009-8976
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Country | US
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Telephone | 760-944-9200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PHILLIP MILGRAM
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Credential | M.D.
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Telephone | 760-944-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A35111
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License Number State | CA
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