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Individual

MRS. SONJA CLAR MELITA MOELLEKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
A3847231
CA
2085R0202X
Diagnostic Radiology Physician
Primary
A52411
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A524110
BC/BS OF CA
CA
05
1114976578
CA
Enumeration date
05/10/2006
Last updated
08/03/2015
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