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NPI Code Detail

MEDICARE: MELVIN MCCALL

MEDICARE:   MELVIN  MCCALL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1154753085
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELVIN MCCALL
Provider Business Mailing Address
First Line : 1700 NORTH LAMB BLVD
Second Line : APARTMENT 232
City : LAS VEGAS
State : NV
Zip : 89115
Country : US
Telephone Number : 702-353-7287
Fax Number :
Provider Business Practice Location Address
First Line : 3216 WEST CHARLESTON BLVD
Second Line : SUITE A
City : LAS VEGAS
State : NV
Zip : 89102
Country : US
Telephone Number : 702-544-4172
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2013
Last Update Date : 08/02/2013

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Directions to “ MELVIN MCCALL ” Practice Location

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