Provider Demographics
NPI:1235236977
Name:VOURLITIS, MELISSA B (DO)
Entity Type:Individual
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First Name:MELISSA
Middle Name:B
Last Name:VOURLITIS
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Gender:F
Credentials:DO
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Mailing Address - Street 1:1144 65TH ST STE F
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1053
Mailing Address - Country:US
Mailing Address - Phone:510-929-1400
Mailing Address - Fax:510-929-1414
Practice Address - Street 1:500 E VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3054
Practice Address - Country:US
Practice Address - Phone:858-832-2500
Practice Address - Fax:858-400-3023
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2023-03-27
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Provider Licenses
StateLicense IDTaxonomies
CA20A7330207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH20399Medicare UPIN