Provider Demographics
NPI:1487783353
Name:JOVANOVIC, MILAN D
Entity type:Individual
Prefix:MR
First Name:MILAN
Middle Name:D
Last Name:JOVANOVIC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4428 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-5829
Mailing Address - Country:US
Mailing Address - Phone:916-214-5763
Mailing Address - Fax:
Practice Address - Street 1:3990 BRANCH CENTER RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-3809
Practice Address - Country:US
Practice Address - Phone:916-876-7653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator