Healthcare Provider Details

I. General information

NPI: 1154875136
Provider Name (Legal Business Name): MELISSA HAQUE MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2016
Last Update Date: 08/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE UCSF MEDICAL CENTRE DEPT OF ANAESTHESIA
SAN FRANCISCO CA
94143-2204
US

IV. Provider business mailing address

1867 PAGE ST APT 2
SAN FRANCISCO CA
94117-1977
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-1000
  • Fax:
Mailing address:
  • Phone: 415-629-4791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number449
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: