Provider Demographics
NPI:1285210070
Name:ANNA MELLOR MD INC
Entity Type:Organization
Organization Name:ANNA MELLOR MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MELLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-645-1024
Mailing Address - Street 1:24325 CRENSHAW BLVD # 209
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5349
Mailing Address - Country:US
Mailing Address - Phone:310-645-1024
Mailing Address - Fax:
Practice Address - Street 1:602 DEEP VALLEY DR STE 314
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3745
Practice Address - Country:US
Practice Address - Phone:310-645-1024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty