Provider Demographics
NPI:1730162652
Name:MELENDEZ, PHILIPP RAMON (MD)
Entity type:Individual
Prefix:DR
First Name:PHILIPP
Middle Name:RAMON
Last Name:MELENDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3535 SAN DIMAS ST
Mailing Address - Street 2:STE 14
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-1661
Mailing Address - Country:US
Mailing Address - Phone:661-325-7103
Mailing Address - Fax:661-325-7132
Practice Address - Street 1:3535 SAN DIMAS ST
Practice Address - Street 2:STE 14
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-1661
Practice Address - Country:US
Practice Address - Phone:661-325-7103
Practice Address - Fax:661-325-7132
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA51130207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A4511300Medicaid
CA00A511300Medicare PIN