Provider Demographics
NPI:1083905558
Name:MELAMED EYE CARE, INC.
Entity Type:Organization
Organization Name:MELAMED EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FOUAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MELAMED
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:323-655-6582
Mailing Address - Street 1:8213 BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-4505
Mailing Address - Country:US
Mailing Address - Phone:323-655-6582
Mailing Address - Fax:323-655-6473
Practice Address - Street 1:8213 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-4505
Practice Address - Country:US
Practice Address - Phone:323-655-6582
Practice Address - Fax:323-655-6473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-02
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEW317AMedicare PIN