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General NPI Number Information
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NPI Number | 1982616793
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Entity Type | Organization
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Legal Business Name | MILO M WEBBER M D, INC
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 3631 CRENSHAW BLVD SUITE 103
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City | LOS ANGELES
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State | CA
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Zip | 90016-4869
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Country | US
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Telephone | 323-730-5600
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Fax | 323-730-5603
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Provider Business Mailing Address
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Address Line | 5205 S SHERBOURNE DR
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City | LOS ANGELES
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State | CA
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Zip | 90056-1127
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Country | US
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Telephone | 310-338-0659
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Fax | 310-338-0659
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Authorized Official
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Title or Position | CEO
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Name | DR. MILO MELVIN WEBBER
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Credential | MD
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Telephone | 310-338-0659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A16893
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License Number State | CA
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