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General NPI Number Information
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NPI Number | 1255413852
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Entity Type | Individual
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Provider Name | MELANIA LIZA BULA MD
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Gender | Female
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 04/05/2024
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Provider Practice Location Address
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Address Line | 725 WELCH RD
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City | PALO ALTO
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State | CA
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Zip | 94304-1601
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Country | US
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Telephone | 650-497-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 3695 GREEN RD UNIT 22778
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City | BEACHWOOD
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State | OH
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Zip | 44122-7939
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Country | US
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Telephone | 330-655-1869
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Fax | 330-655-3828
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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 | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | DR.0048992
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | 2005-00143
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A111302
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 200500143
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | A111302
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License Number State | CA
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