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General NPI Number Information
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NPI Number | 1750448981
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Entity Type | Individual
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Provider Name | CARL M MELINA MD
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Gender | Male
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 10/28/2012
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Provider Practice Location Address
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Address Line | 18610 NW CORNELL ROAD SUITE 100
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City | HILLSBORO
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State | OR
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Zip | 97124-9923
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Country | US
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Telephone | 503-216-9360
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Fax | 503-216-9363
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Provider Business Mailing Address
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Address Line | PO BOX 3158
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City | PORTLAND
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State | OR
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Zip | 97208-3158
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Country | US
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Telephone | 503-215-6494
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Fax |
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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 | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | M-3948
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD28596
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License Number State | OR
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