Provider Demographics
NPI:1053419473
Name:MILIN, JUDI G (DC)
Entity type:Individual
Prefix:DR
First Name:JUDI
Middle Name:G
Last Name:MILIN
Suffix:
Gender:F
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:PO BOX 3157
Mailing Address - Street 2:
Mailing Address - City:IDYLLWILD
Mailing Address - State:CA
Mailing Address - Zip Code:92549-3157
Mailing Address - Country:US
Mailing Address - Phone:951-659-4522
Mailing Address - Fax:
Practice Address - Street 1:55450 S. CIRCLE DR.
Practice Address - Street 2:
Practice Address - City:IDYLLWILD
Practice Address - State:CA
Practice Address - Zip Code:92549-3157
Practice Address - Country:US
Practice Address - Phone:951-659-4522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16635111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0166350Medicare ID - Type Unspecified