Provider Demographics
NPI:1750902326
Name:NAD MD INC.
Entity type:Organization
Organization Name:NAD MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:MILGRAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-776-0544
Mailing Address - Street 1:444 N EL CAMINO REAL SPC 123
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1317
Mailing Address - Country:US
Mailing Address - Phone:760-944-9200
Mailing Address - Fax:760-692-4411
Practice Address - Street 1:3262 HOLIDAY CT STE 210
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1811
Practice Address - Country:US
Practice Address - Phone:760-944-9200
Practice Address - Fax:760-692-4411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-05
Last Update Date:2023-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate HealthGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1194450023OtherNPPES