Provider Demographics
NPI:1902414097
Name:MILUS, ALEXA TAYLOR (DC)
Entity Type:Individual
Prefix:DR
First Name:ALEXA
Middle Name:TAYLOR
Last Name:MILUS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4950 GOLDEN RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6040
Mailing Address - Country:US
Mailing Address - Phone:925-216-5736
Mailing Address - Fax:
Practice Address - Street 1:5653 STONERIDGE DR STE 101
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-8543
Practice Address - Country:US
Practice Address - Phone:925-858-4375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34868111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty