MEDICARE: DR. MELISSA KAGNOFF M.D.

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
1	2084N0400X	Neurology Physician	27100	NE
2	2084N0400X	Neurology Physician	A121332	CA
3	2084N0400X	Neurology Physician	58383	AZ
4	2084N0400X	Neurology Physician	66706	GA
5	207T00000X	Neurological Surgery Physician	A121332	CA

General Provider Information

NPI Number	:	1679764179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELISSA KAGNOFF M.D.

Provider Business Mailing Address
First Line	:	PO BOX 10880
Second Line	:
City	:	PRESCOTT
State	:	AZ
Zip	:	86304-0880
Country	:	US
Telephone Number	:	928-759-5874
Fax Number	:	928-458-2039

Provider Business Practice Location Address
First Line	:	6699 ALVARADO RD
Second Line	:	SUITE 2301
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-5244
Country	:	US
Telephone Number	:	619-582-2595
Fax Number	:	619-229-8006

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2007
Last Update Date	:	09/08/2021

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:

211 CALLE MORSE
ARROYO, PR
00714-2350

Practice Phone: 787-839-3980
Practice Fax: 787-271-2515

1598761413 — DR. DOUGLAS DEAN DENGERINK D.O.
Practice Location Address:

6699 ALVARADO RD , SUITE 2100
SAN DIEGO, CA
92120-5244

Practice Phone: 619-229-3909
Practice Fax: 619-229-3902

1356449425 — DR. TREVOR HOWARD HENDERSON MD
Practice Location Address:

6699 ALVARADO RD , SUITE 2200
SAN DIEGO, CA
92120-5244

Practice Phone: 619-265-3400
Practice Fax: 619-265-3407

1952496291 — OLEG M GAVRILYUK M.D.
Practice Location Address:

6699 ALVARADO RD , STE. 2302
SAN DIEGO, CA
92120-5244

Practice Phone: 619-578-2518
Practice Fax: 619-501-6498

1619004421 — PULMONARY MEDICINE & INFECTIOUS DISEASE MEDICAL GROUP
Practice Location Address:

6699 ALVARADO RD , SUITE 2308
SAN DIEGO, CA
92120-5244

Practice Phone: 619-462-9010
Practice Fax: 619-287-8165

1124220181 — SAN DIEGO INSTITUTE OF GASTROENTEROLOGY AND NUTRITION
Practice Location Address:

6699 ALVARADO RD , SUITE 2301
SAN DIEGO, CA
92120-5244

Practice Phone: 619-229-1005
Practice Fax: 619-326-0380

Directions to “ DR. MELISSA KAGNOFF M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.