Provider Demographics
NPI:1093859530
Name:MELLINS, ELIZABETH DEBORAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:DEBORAN
Last Name:MELLINS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:838 ESPLANADA WAY
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-1015
Mailing Address - Country:US
Mailing Address - Phone:650-498-7350
Mailing Address - Fax:650-498-6077
Practice Address - Street 1:725 WELCH RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1601
Practice Address - Country:US
Practice Address - Phone:650-498-7350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-17
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG841602080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology