Provider Demographics
NPI:1730286626
Name:LYND, MELODY (MELODY LYND)
Entity Type:Individual
Prefix:DR
First Name:MELODY
Middle Name:
Last Name:LYND
Suffix:
Gender:F
Credentials:MELODY LYND
Other - Prefix:DR
Other - First Name:MELODY
Other - Middle Name:LYNN
Other - Last Name:YAMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MELODY LYND
Mailing Address - Street 1:2125 VIZCAYA WAY
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-5654
Mailing Address - Country:US
Mailing Address - Phone:408-893-4887
Mailing Address - Fax:408-356-7195
Practice Address - Street 1:2450 SAMARITAN DR
Practice Address - Street 2:SUITE 2
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-3912
Practice Address - Country:US
Practice Address - Phone:408-356-6719
Practice Address - Fax:408-356-7195
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG86621208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH15792Medicare UPIN