Healthcare Provider Details

I. General information

NPI: 1750463832
Provider Name (Legal Business Name): MELINDA ABELES PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5185 HOSPITAL RD JOHN C FREMONT RURAL HEALTH
MARIPOSA CA
95338
US

IV. Provider business mailing address

BOX 432
MIDPINES CA
95345-0432
US

V. Phone/Fax

Practice location:
  • Phone: 209-966-3631
  • Fax:
Mailing address:
  • Phone: 209-966-8395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA12252
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: