Provider Demographics
NPI:1831749142
Name:MILAN, KIMBERLY LEE
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:LEE
Last Name:MILAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 E 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4908
Mailing Address - Country:US
Mailing Address - Phone:760-893-6515
Mailing Address - Fax:
Practice Address - Street 1:127 BAHIA LN
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-2079
Practice Address - Country:US
Practice Address - Phone:619-277-1348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider