Provider Demographics
NPI:1285655399
Name:MILNE, LAWRENCE W (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:W
Last Name:MILNE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7777 GREENBACK LN
Mailing Address - Street 2:STE. 103
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-5800
Mailing Address - Country:US
Mailing Address - Phone:916-835-7777
Mailing Address - Fax:916-560-3320
Practice Address - Street 1:7777 GREENBACK LN STE 103
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-5800
Practice Address - Country:US
Practice Address - Phone:916-835-7777
Practice Address - Fax:888-420-0067
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG69307208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G693070Medicaid
CAE85895Medicare UPIN