Provider Demographics
NPI:1104565977
Name:KAMANSKY, MILTON (PA-C)
Entity type:Individual
Prefix:
First Name:MILTON
Middle Name:
Last Name:KAMANSKY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18645 COLLINS ST APT 14
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2184
Mailing Address - Country:US
Mailing Address - Phone:818-462-3814
Mailing Address - Fax:
Practice Address - Street 1:1401 GARCES HWY
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-3660
Practice Address - Country:US
Practice Address - Phone:661-721-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA61134207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine