Provider Demographics
NPI:1750463832
Name:ABELES, MELINDA (PA)
Entity Type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:
Last Name:ABELES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 432
Mailing Address - Street 2:
Mailing Address - City:MIDPINES
Mailing Address - State:CA
Mailing Address - Zip Code:95345-0432
Mailing Address - Country:US
Mailing Address - Phone:209-966-8395
Mailing Address - Fax:
Practice Address - Street 1:5185 HOSPITAL RD
Practice Address - Street 2:JOHN C FREMONT RURAL HEALTH
Practice Address - City:MARIPOSA
Practice Address - State:CA
Practice Address - Zip Code:95338
Practice Address - Country:US
Practice Address - Phone:209-966-3631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA12252363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA12252OtherPAEC