Provider Demographics
NPI:1508862814
Name:MELTZER, RICHARD M (DPM)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
Last Name:MELTZER
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:15100 LOS GATOS BLVD
Mailing Address - Street 2:STE 4
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2028
Mailing Address - Country:US
Mailing Address - Phone:408-358-6234
Mailing Address - Fax:408-358-3389
Practice Address - Street 1:15100 LOS GATOS BLVD
Practice Address - Street 2:STE 4
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2028
Practice Address - Country:US
Practice Address - Phone:408-358-6234
Practice Address - Fax:408-358-3389
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE2929213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT11519Medicare UPIN
CA000E29290Medicare PIN
CA0938060001Medicare NSC