Provider Demographics
NPI:1972509396
Name:MELO, LEMUEL CRUZ
Entity Type:Individual
Prefix:MR
First Name:LEMUEL
Middle Name:CRUZ
Last Name:MELO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14712 JACANA DR
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-4554
Mailing Address - Country:US
Mailing Address - Phone:714-521-8349
Mailing Address - Fax:714-521-8218
Practice Address - Street 1:14712 JACANA DR
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-4554
Practice Address - Country:US
Practice Address - Phone:714-521-8349
Practice Address - Fax:714-521-8218
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy