Provider Demographics
NPI:1063423861
Name:MILAZZO, CAROL FRANCES (MD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:FRANCES
Last Name:MILAZZO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:406 SUNRISE AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4106
Mailing Address - Country:US
Mailing Address - Phone:916-782-3786
Mailing Address - Fax:916-773-6251
Practice Address - Street 1:406 SUNRISE AVE
Practice Address - Street 2:SUITE 280
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4106
Practice Address - Country:US
Practice Address - Phone:916-782-3786
Practice Address - Fax:916-773-6251
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG852722080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACLR 327134Medicaid
CA00G852720Medicaid
CAE95310Medicare UPIN
CACLR 327134Medicaid