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General NPI Number Information
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NPI Number | 1689719551
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Entity Type | Organization
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Legal Business Name | MELANIE A. FARRELL, M.D., A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 01/04/2010
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Provider Practice Location Address
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Address Line | 9834 GENESEE AVE SUITE 312
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City | LA JOLLA
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State | CA
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Zip | 92037-1223
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Country | US
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Telephone | 858-558-7852
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Fax | 858-558-7601
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Provider Business Mailing Address
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Address Line | 9834 GENESEE AVE SUITE 312
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City | LA JOLLA
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State | CA
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Zip | 92037-1223
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Country | US
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Telephone | 858-558-7852
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Fax | 858-558-7601
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Authorized Official
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Title or Position | PRESIDENT
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Name | MELANIE A. FARRELL
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Credential | M.D.
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Telephone | 858-558-7852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | G61110
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License Number State | CA
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