Provider Demographics
NPI:1154612059
Name:MILO, RAZEL BACUETES (PHD, DNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:RAZEL
Middle Name:BACUETES
Last Name:MILO
Suffix:
Gender:F
Credentials:PHD, DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 E PENNSYLVANIA AVE STE C
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3004
Mailing Address - Country:US
Mailing Address - Phone:760-855-6416
Mailing Address - Fax:
Practice Address - Street 1:739 E PENNSYLVANIA AVE STE C
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3004
Practice Address - Country:US
Practice Address - Phone:760-855-6416
Practice Address - Fax:619-566-3622
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20512363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily