Provider Demographics
NPI:1881713162
Name:PAYNE, MILTON LA VON (DC)
Entity type:Individual
Prefix:DR
First Name:MILTON
Middle Name:LA VON
Last Name:PAYNE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7120 HAYVENHURST AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-3843
Mailing Address - Country:US
Mailing Address - Phone:818-787-7375
Mailing Address - Fax:818-787-7320
Practice Address - Street 1:7120 HAYVENHURST AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3843
Practice Address - Country:US
Practice Address - Phone:818-787-7375
Practice Address - Fax:818-787-7320
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16802111N00000X
NC3666111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC16802Medicare ID - Type Unspecified