Healthcare Provider Details

I. General information

NPI: 1497967459
Provider Name (Legal Business Name): MELISSA ANN NOONE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 01/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11234 ANDERSON ST
LOMA LINDA CA
92354-2804
US

IV. Provider business mailing address

28606 GREENVILLE CIR
HIGHLAND CA
92346-5728
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-8131
  • Fax:
Mailing address:
  • Phone: 951-314-3098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA102173
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: