Healthcare Provider Details

I. General information

NPI: 1568509834
Provider Name (Legal Business Name): MELODY LAW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 10/13/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 EAST PKWY STE 600
SACRAMENTO CA
95823-2501
US

IV. Provider business mailing address

SACRAMENTO COUNTY PUBLIC HEALTH 7001-A EAST PARKWAY SUITE 600
SACRAMENTO CA
95823
US

V. Phone/Fax

Practice location:
  • Phone: 168-755-8819
  • Fax:
Mailing address:
  • Phone: 916-875-5881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberA113809
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: