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General NPI Number Information
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NPI Number | 1710761077
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Entity Type | Organization
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Legal Business Name | MELLIE INC
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Dates
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Enumeration Date | 08/18/2023
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Last Update Date | 08/18/2023
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Provider Practice Location Address
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Address Line | 44 MONTGOMERY ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94104-4602
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Country | US
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Telephone | 415-869-6114
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Fax |
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Provider Business Mailing Address
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Address Line | 3145 GEARY BLVD # 724
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-3316
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CARE
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Name | TRACI DOBRONRAVOVA
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Credential |
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Telephone | 415-869-6114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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