Provider Demographics
NPI:1043415888
Name:DEER, MELISSA EVELYN HEART (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:EVELYN HEART
Last Name:DEER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2630 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-6529
Mailing Address - Country:US
Mailing Address - Phone:619-234-2158
Mailing Address - Fax:619-234-0206
Practice Address - Street 1:2630 1ST AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-6599
Practice Address - Country:US
Practice Address - Phone:619-234-2158
Practice Address - Fax:619-234-0206
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1079212084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGV912ZMedicare PIN
CAW416Medicare PIN