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General NPI Number Information
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NPI Number | 1891652103
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Entity Type | Organization
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Legal Business Name | MILK WISE MEDICAL, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 1848 COMMERCIAL ST
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City | SAN DIEGO
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State | CA
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Zip | 92113-1037
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Country | US
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Telephone | 858-204-7349
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Fax |
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Provider Business Mailing Address
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Address Line | 5538 IRONDALE AVE
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-6840
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Country | US
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Telephone | 818-216-2319
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RAJY ABULHOSN
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Credential | MD
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Telephone | 858-204-7349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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