Provider Demographics
NPI:1841467263
Name:ALBA, MELINDA L (MD, MS)
Entity type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:L
Last Name:ALBA
Suffix:
Gender:F
Credentials:MD, MS
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Mailing Address - Street 1:13640 N PLAZA DEL RIO BLVD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4846
Mailing Address - Country:US
Mailing Address - Phone:623-876-6922
Mailing Address - Fax:623-972-9590
Practice Address - Street 1:13640 N PLAZA DEL RIO BLVD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4846
Practice Address - Country:US
Practice Address - Phone:623-876-6922
Practice Address - Fax:623-972-9590
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2019-10-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN59854207Q00000X
WI63551-20207Q00000X
MS23698207Q00000X
ND13584207Q00000X
IAMD-40656207Q00000X
AZ40726207Q00000X
TXQ3322207Q00000X
CAC140869207Q00000X
GA74853207Q00000X
UT9114006-1205207Q00000X
KS04-37528207Q00000X
MO2014030682207Q00000X
ALMD.33713207Q00000X
SD9338207Q00000X
IL036.120402207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ354354Medicaid
AZZ123264Medicare PIN