Provider Demographics
NPI:1497865836
Name:MELKONIAN, RITA (MD)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:MELKONIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 CASA BUENA DR
Mailing Address - Street 2:STE B
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1762
Mailing Address - Country:US
Mailing Address - Phone:415-924-3530
Mailing Address - Fax:415-924-3573
Practice Address - Street 1:101 CASA BUENA DR
Practice Address - Street 2:STE B
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1762
Practice Address - Country:US
Practice Address - Phone:415-924-3530
Practice Address - Fax:415-924-3573
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2012-05-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA38845207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology