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Organization

MILK BAR COLLECTIVE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ADITYA RAVIKUMAR (CHIEF OPERATING OFFICER)
(415) 867-6115
Entity
Organization

Contact information

Practice address
5030 CAMINO DE LA SIESTA STE 206, SAN DIEGO, CA 92108-3118
(415) 867-6115
Mailing address
3158 W 152ND PL, GARDENA, CA 90249-4006

Taxonomy

Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
174N00000X
Lactation Consultant (Non-RN)
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist

Other

Enumeration date
08/17/2024
Last updated
08/20/2024
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