1003054388 NPI number — MELVINA MACHELLE ZENO CAADE

Table of content: MELVINA MACHELLE ZENO CAADE (NPI 1003054388)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003054388 NPI number — MELVINA MACHELLE ZENO CAADE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZENO
Provider First Name:
MELVINA
Provider Middle Name:
MACHELLE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CAADE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003054388
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/11/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1060 HOWARD ST FL 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94103-2820
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-312-0964
Provider Business Mailing Address Fax Number:
415-822-3838

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1060 HOWARD ST 3RD FLOOR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-312-0964
Provider Business Practice Location Address Fax Number:
415-822-3838
Provider Enumeration Date:
01/26/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)