Provider Demographics
NPI:1295263770
Name:TAWFIK, MELANIE EMAD (MD)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:EMAD
Last Name:TAWFIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:MELANIE
Other - Middle Name:EMAD
Other - Last Name:MASOUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:25865 BARTON RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3896
Mailing Address - Country:US
Mailing Address - Phone:909-558-2890
Mailing Address - Fax:
Practice Address - Street 1:25865 BARTON RD STE 101
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3896
Practice Address - Country:US
Practice Address - Phone:909-558-2890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA157076207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology