Provider Demographics
NPI:1730270737
Name:FIALA, MILAN (MD)
Entity type:Individual
Prefix:DR
First Name:MILAN
Middle Name:
Last Name:FIALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 UCLA MEDICAL PLZ
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-7022
Mailing Address - Country:US
Mailing Address - Phone:310-206-6392
Mailing Address - Fax:310-825-2042
Practice Address - Street 1:100 UCLA MEDICAL PLZ
Practice Address - Street 2:SUITE 220
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-7022
Practice Address - Country:US
Practice Address - Phone:310-206-6392
Practice Address - Fax:310-825-2042
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA23625207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A236250Medicaid
A23621Medicare UPIN
CA00A236250Medicaid