Healthcare Provider Details

I. General information

NPI: 1710022611
Provider Name (Legal Business Name): DONALD ALBERT MELAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 06/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 S LASKY DR SUITE 8
BEVERLY HILLS CA
90212-1721
US

IV. Provider business mailing address

2047 LAUGHLIN PARK DR
LOS ANGELES CA
90027-1711
US

V. Phone/Fax

Practice location:
  • Phone: 888-692-5053
  • Fax: 323-666-8834
Mailing address:
  • Phone: 888-692-5053
  • Fax: 323-666-8834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberG68753
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG68753
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberG68753
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: