Provider Demographics
NPI:1730281767
Name:ATIENZA, MELINDA UMALI (DO)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:UMALI
Last Name:ATIENZA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MRS
Other - First Name:MELINDA
Other - Middle Name:ATIENZA
Other - Last Name:BURSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11020 E IRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-4868
Mailing Address - Country:US
Mailing Address - Phone:480-789-3057
Mailing Address - Fax:480-563-3060
Practice Address - Street 1:8962 E DESERT COVE AVE STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6984
Practice Address - Country:US
Practice Address - Phone:480-744-7110
Practice Address - Fax:480-563-3060
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4483207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ133482Medicaid
IL36099869Medicaid
AZ133482Medicaid
918140Medicare ID - Type Unspecified
IL36099869Medicaid
G97366Medicare UPIN