| Michael D. Mello, M.d., A Professional Corporation | |
|
1818 Verdugo Blvd Ste 107 Glendale CA 91208-1400 | |
| (818) 790-0122 | |
| (818) 790-4623 |
| Full Name | Michael D. Mello, M.d., A Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 1818 Verdugo Blvd Ste 107, Glendale, California |
| Authorized Official Name and Position | Barbara Susan Mello (OFFICE MANAGER/CORPORATE SECRETARY) |
| Authorized Official Contact | 8187900122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael D. Mello, M.d., A Professional Corporation 1818 Verdugo Blvd Ste 107 Glendale CA 91208-1400 Ph: (818) 790-0122 | Michael D. Mello, M.d., A Professional Corporation 1818 Verdugo Blvd Ste 107 Glendale CA 91208-1400 Ph: (818) 790-0122 |
| NPI Number | 1407557408 |
|---|---|
| Provider Enumeration Date | 03/15/2023 |
| Last Update Date | 05/01/2023 |
| Medicare PECOS PAC ID | 9032576012 |
|---|---|
| Medicare Enrollment ID | O20230607000091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407557408 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Michael David Mello |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356571566 PECOS PAC ID: 3678703287 Enrollment ID: I20160714002081 |
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