Provider Demographics
NPI:1205834702
Name:MELNYK, OSTAP G (MD)
Entity Type:Individual
Prefix:DR
First Name:OSTAP
Middle Name:G
Last Name:MELNYK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4721 DALLAS RANCH ROAD
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-8811
Mailing Address - Country:US
Mailing Address - Phone:925-778-0679
Mailing Address - Fax:925-778-3567
Practice Address - Street 1:13847 E 14TH ST
Practice Address - Street 2:SUITE 217
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-2626
Practice Address - Country:US
Practice Address - Phone:510-483-2555
Practice Address - Fax:510-483-1856
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2013-05-14
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Provider Licenses
StateLicense IDTaxonomies
CAG66164207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF69137Medicare UPIN
CA00G661640Medicare PIN