Provider Demographics
NPI:1861437691
Name:MILANO, ALAN (OD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:MILANO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47860 WARM SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-7459
Mailing Address - Country:US
Mailing Address - Phone:510-651-3937
Mailing Address - Fax:
Practice Address - Street 1:47860 WARM SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-7459
Practice Address - Country:US
Practice Address - Phone:510-651-3937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-17
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7569152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0075690Medicaid
CASD0075690Medicaid
CASD0075690Medicare PIN
CAT10560Medicare UPIN
CA0561340001Medicare NSC