Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | E1717 | CA |
NPI | 1316995426 |
---|---|
Provider Name | Dr. Sanford Jack Milner |
First Address | Camarillo, CA 93010-1501 |
Second Address | Camarillo, CA 93010-1505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 08/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T19131 | (02) | CA |