Agereversalmd.Com A Professional Corporation
LBN: Agereversalmd.Com A Professional Corporation
Agereversalmd.Com A Professional Corporation is an health care organization with primary practice located at 3252 Holiday Ct Ste 211 , La Jolla CA 92037-0027. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecology, Agencies / Public Health or Welfare, Ambulatory Health Care Facilities / Primary Care, Ambulatory Health Care Facilities / Pain. Agencies / Public Health or Welfare is the primary health care specialty.
Agereversalmd.Com A Professional Corporation can be contacted via phone (858) 776-0544, or through Milgram, Phillip Mark via phone (858) 776-0544.
Contact Information
Primary practice address
3252 Holiday Ct Ste 211
La Jolla CA 92037-0027
Phone: (858) 776-0544
Fax: (760) 692-4411
Website:
Authorized official contact:
Name: Milgram, Phillip Mark Doctor of Medicine (MD)
Phone: (858) 776-0544
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | ||
| Agencies / Public Health or Welfare | 251K00000X | ||
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | ||
| Ambulatory Health Care Facilities / Pain | 261QP3300X |
Profile Details
| NPI number | 1194450023 |
|---|---|
| LBN Legal business name | Agereversalmd.Com A Professional Corporation |
| DBA Doing business as | |
| Authorized official | Milgram, Phillip Mark Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 24th, 2022 |
| Last updated | Jul 24th, 2022 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194450023 | NPPES |
| California | Other | 1285737569 | INDIVIDUAL NPI |
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