Provider Demographics
NPI:1073577433
Name:GURNEY, MELVIN L (MD)
Entity Type:Individual
Prefix:
First Name:MELVIN
Middle Name:L
Last Name:GURNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 MARCH AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-3367
Mailing Address - Country:US
Mailing Address - Phone:707-433-1111
Mailing Address - Fax:707-433-1144
Practice Address - Street 1:421 MARCH AVE
Practice Address - Street 2:SUITE C
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-3367
Practice Address - Country:US
Practice Address - Phone:707-433-1111
Practice Address - Fax:707-433-1144
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG60352174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE25163Medicare UPIN
CA00G603521Medicare ID - Type Unspecified