MEDICARE: MELINDA LUZ AQUINO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician	A94731	CA

General Provider Information

NPI Number	:	1033190970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELINDA LUZ AQUINO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 590455
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94159-0455
Country	:	US
Telephone Number	:	650-991-1122
Fax Number	:	415-744-1199

Provider Business Practice Location Address
First Line	:	2250 HAYES ST STE 612
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94117-1078
Country	:	US
Telephone Number	:	415-752-1122
Fax Number	:	415-744-1199

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	12/17/2019

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