Healthcare Provider Details

I. General information

NPI: 1508846387
Provider Name (Legal Business Name): GREGORY P MELCHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 07/05/2022
Certification Date: 07/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518A CASTRO ST
SAN FRANCISCO CA
94114-2512
US

IV. Provider business mailing address

PO BOX 743749
LOS ANGELES CA
90074-3749
US

V. Phone/Fax

Practice location:
  • Phone: 415-552-2814
  • Fax: 415-552-2909
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number00G869540
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: