Provider Demographics
NPI:1861153140
Name:MELISSA DRAKE MD INC
Entity type:Organization
Organization Name:MELISSA DRAKE MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:GEORGENSON
Authorized Official - Last Name:DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-455-6500
Mailing Address - Street 1:504 W PUEBLO ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-6211
Mailing Address - Country:US
Mailing Address - Phone:805-455-6500
Mailing Address - Fax:805-770-3935
Practice Address - Street 1:504 W PUEBLO ST STE 202
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-6211
Practice Address - Country:US
Practice Address - Phone:805-455-6500
Practice Address - Fax:805-770-3935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty