Provider Demographics
NPI:1619596269
Name:ADLOO, MILAD (DPM)
Entity Type:Individual
Prefix:
First Name:MILAD
Middle Name:
Last Name:ADLOO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 S LA CIENEGA BLVD APT 3110
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-4337
Mailing Address - Country:US
Mailing Address - Phone:678-548-9000
Mailing Address - Fax:
Practice Address - Street 1:2121 WILSHIRE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5742
Practice Address - Country:US
Practice Address - Phone:310-828-0011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-14
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5926213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty