Healthcare Provider Details

I. General information

NPI: 1336024546
Provider Name (Legal Business Name): MELANIE A COLON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGARA COLON

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/07/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 TURK ST
SAN FRANCISCO CA
94102-3703
US

IV. Provider business mailing address

392 11TH ST UNIT 506
OAKLAND CA
94607-4266
US

V. Phone/Fax

Practice location:
  • Phone: 628-202-2164
  • Fax:
Mailing address:
  • Phone: 347-290-1827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: