Individual
ETAN MILGROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
849 W 34TH ST, LOS ANGELES, CA 90089-0079
(213) 740-0225
Mailing address
849 W 34TH ST, LOS ANGELES, CA 90089-0079
(213) 740-0225
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
G59018
CA
207Q00000X
Family Medicine Physician
G59018
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00590180
MEDICAL PPIN #
CA
Enumeration date
08/10/2006
Last updated
09/11/2025
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