Provider Demographics
NPI:1295810166
Name:MILLENIUM PRO, INC.
Entity type:Organization
Organization Name:MILLENIUM PRO, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VEERPAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-612-0248
Mailing Address - Street 1:3435 WILSHIRE BLVD STE 2890
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-1938
Mailing Address - Country:US
Mailing Address - Phone:213-480-6211
Mailing Address - Fax:213-480-6216
Practice Address - Street 1:3435 WILSHIRE BLVD STE 2890
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-1938
Practice Address - Country:US
Practice Address - Phone:213-480-6211
Practice Address - Fax:213-480-6216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980000900251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA70270GOtherMEDI-CAL PROVIDER #