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General NPI Number Information
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NPI Number | 1205834702
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Entity Type | Individual
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Provider Name | OSTAP G MELNYK MD
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Gender | Male
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 05/14/2013
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Provider Practice Location Address
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Address Line | 13847 E 14TH ST SUITE 217
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City | SAN LEANDRO
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State | CA
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Zip | 94578-2626
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Country | US
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Telephone | 510-483-2555
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Fax | 510-483-1856
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Provider Business Mailing Address
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Address Line | 4721 DALLAS RANCH ROAD
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City | ANTIOCH
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State | CA
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Zip | 94531-8811
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Country | US
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Telephone | 925-778-0679
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Fax | 925-778-3567
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | G66164
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License Number State | CA
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