Provider Demographics
NPI:1811570211
Name:MILESTONE PEDIATRICS, INC.
Entity Type:Organization
Organization Name:MILESTONE PEDIATRICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:PACHECO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:559-746-7337
Mailing Address - Street 1:3435 S DEMAREE ST STE A
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-7006
Mailing Address - Country:US
Mailing Address - Phone:559-746-7337
Mailing Address - Fax:559-746-7746
Practice Address - Street 1:3435 S DEMAREE ST STE A
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-7006
Practice Address - Country:US
Practice Address - Phone:559-746-7337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-03
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty