Provider Demographics
NPI:1033293576
Name:MELENDEZ, SUNNY (MD)
Entity Type:Individual
Prefix:
First Name:SUNNY
Middle Name:
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2841 LOMITA BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5105
Mailing Address - Country:US
Mailing Address - Phone:310-542-7733
Mailing Address - Fax:310-542-8077
Practice Address - Street 1:2841 LOMITA BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5105
Practice Address - Country:US
Practice Address - Phone:310-542-7733
Practice Address - Fax:310-542-8077
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44230207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
E95454Medicare UPIN
A44230Medicare ID - Type Unspecified