Individual
MELANIE A. FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9834 GENESEE AVE, SUITE 312, LA JOLLA, CA 92037-1223
(858) 558-8150
(858) 346-1024
Mailing address
9610 GRANITE RIDGE DR, STE B, SAN DIEGO, CA 92123-2684
(858) 810-8000
(858) 268-1911
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G61110
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G611100
BLUE SHIELD
CA
05
—
00G611100
—
CA
01
—
CA127954
NO. CALIFORNIA PTAN
CA
01
—
CD880Z
SO. CALIFORNIA PTAN
CA
Enumeration date
09/02/2006
Last updated
09/18/2015
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