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General NPI Number Information
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NPI Number | 1750902326
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Entity Type | Organization
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Legal Business Name | NAD MD INC.
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Dates
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Enumeration Date | 05/05/2020
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Last Update Date | 05/28/2023
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Provider Practice Location Address
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Address Line | 3262 HOLIDAY CT STE 210
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City | LA JOLLA
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State | CA
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Zip | 92037-1811
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Country | US
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Telephone | 760-944-9200
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Fax | 760-692-4411
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Provider Business Mailing Address
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Address Line | 444 N EL CAMINO REAL SPC 123
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City | ENCINITAS
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State | CA
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Zip | 92024-1317
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Country | US
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Telephone | 760-944-9200
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Fax | 760-692-4411
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Authorized Official
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Title or Position | CEO
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Name | PHILLIP MARK MILGRAM
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Credential | MD
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Telephone | 858-776-0544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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