Provider Demographics
NPI:1629016316
Name:MILGRAM, LYNNE H (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:H
Last Name:MILGRAM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:15395 ISLA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:JAMUL
Mailing Address - State:CA
Mailing Address - Zip Code:91935-3400
Mailing Address - Country:US
Mailing Address - Phone:619-669-3902
Mailing Address - Fax:858-636-2223
Practice Address - Street 1:8695 SPECTRUM CENTER BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1489
Practice Address - Country:US
Practice Address - Phone:858-499-4452
Practice Address - Fax:858-636-2223
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA35474207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA27797Medicare UPIN