Provider Demographics
NPI:1497825541
Name:MELAMED, PETER (LAC, PHD)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:MELAMED
Suffix:
Gender:M
Credentials:LAC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 POST ST STE 1
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3427
Mailing Address - Country:US
Mailing Address - Phone:415-409-3939
Mailing Address - Fax:
Practice Address - Street 1:2215 POST ST STE 1
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3427
Practice Address - Country:US
Practice Address - Phone:415-409-3939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA5505171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist