Organization
ELITE PHYSICAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEAN O MILAM D.C. (CLINIC DIRECTOR)
(714) 731-9355
Entity
Organization
Contact information
Practice address
217 EL CAMINO REAL, TUSTIN, CA 92780-3603
(714) 731-9355
(714) 544-1538
Mailing address
217 EL CAMINO REAL, TUSTIN, CA 92780-3603
(714) 731-9355
(714) 544-1538
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
—
CA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
CA
Other
Enumeration date
01/31/2013
Last updated
01/31/2013
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