Provider Demographics
NPI:1558339119
Name:MILANO, ELVIRA A (MD)
Entity Type:Individual
Prefix:
First Name:ELVIRA
Middle Name:A
Last Name:MILANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2390
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95241-2390
Mailing Address - Country:US
Mailing Address - Phone:408-891-0837
Mailing Address - Fax:209-367-1575
Practice Address - Street 1:975 S FAIRMONT AVE
Practice Address - Street 2:CONRAD BUILDING
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240-5118
Practice Address - Country:US
Practice Address - Phone:209-339-7585
Practice Address - Fax:209-367-1575
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52482207ZP0102X, 207ZB0001X, 207ZC0500X, 207ZD0900X, 207ZH0000X, 207ZI0100X, 207ZM0300X, 207ZN0500X, 207ZP0104X, 207ZP0105X, 207ZP0213X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
No207ZI0100XAllopathic & Osteopathic PhysiciansPathologyImmunopathology
No207ZM0300XAllopathic & Osteopathic PhysiciansPathologyMedical Microbiology
No207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology
No207ZP0104XAllopathic & Osteopathic PhysiciansPathologyChemical Pathology
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
No207ZP0213XAllopathic & Osteopathic PhysiciansPathologyPediatric Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALAB09388FMedicaid
CAP00191221OtherRAILROAD MEDICARE NO
CA00A524824OtherMEDICARE PTAN
CALAB09388FMedicaid