Organization
NAD MD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP MARK MILGRAM MD (CEO)
(858) 776-0544
Entity
Organization
Contact information
Practice address
3262 HOLIDAY CT STE 210, LA JOLLA, CA 92037-1811
(760) 944-9200
(760) 692-4411
Mailing address
444 N EL CAMINO REAL SPC 123, ENCINITAS, CA 92024-1317
(760) 944-9200
(760) 692-4411
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
261QC1800X
Corporate Health Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194450023
NPPES
CA
Enumeration date
05/05/2020
Last updated
05/28/2023
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