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General NPI Number Information
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NPI Number | 1669755740
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Entity Type | Individual
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Provider Name | PETER KELSEY ZAKEVICH MILANO M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/24/2011
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Last Update Date | 09/24/2011
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Provider Practice Location Address
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Address Line | 1200 N STATE ST GME OFFICE, CLINIC TOWER A7D
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City | LOS ANGELES
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State | CA
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Zip | 90033-1029
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Country | US
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Telephone | 786-512-6311
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Fax |
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Provider Business Mailing Address
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Address Line | 5974 SW 59TH ST
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-2269
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Country | US
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Telephone | 786-512-6311
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A118513
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License Number State | CA
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