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NPI Code Detail

MEDICARE: MELISSA J. CARUCCI MD

MEDICARE: MELISSA J. CARUCCI MD
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
1207R00000XInternal Medicine PhysicianA62207CA

General Provider Information

NPI Number : 1376621813
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA J. CARUCCI MD
Provider Business Mailing Address
First Line : 1800 HARRISON ST FL 7
Second Line :
City : OAKLAND
State : CA
Zip : 94612-3466
Country : US
Telephone Number : 510-625-6262
Fax Number :
Provider Business Practice Location Address
First Line : 5601 DEER VALLEY RD
Second Line :
City : ANTIOCH
State : CA
Zip : 94531-8577
Country : US
Telephone Number : 925-813-6500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 12/13/2021

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