Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | A89541 | CA |
N | 207R00000X | Internist | 229774 | NY |
N | 111NI0900X | Internist | 229774 | NY |
Y | 207R00000X | Internist | A89541 | CA |
Y | 111NI0900X | Internist | A89541 | CA |
N | 207RA0201X | Internist - Allergy & Immunology | A89541 | CA |
NPI | 1922286228 |
---|---|
Provider Name | Dr. David P Melamed |
First Address | Los Angeles, CA 90025-6613 |
Second Address | Los Angeles, CA 90025-6613 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2008 |
Last Update Date | 08/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I00671 | (02) | CA |