Individual
MELINDA JANE BRASKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(323) 361-2501
(323) 361-1191
Mailing address
3701 WILSHIRE BLVD, SUITE 600, LOS ANGELES, CA 90010-2804
(323) 361-2337
(323) 361-8491
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
A83104
CA
208000000X
Pediatrics Physician
A83104
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A831040
BLUE SHIELD
—
05
—
00A831040
—
CA
01
—
A83104
BLUE CROSS
—
Enumeration date
04/03/2006
Last updated
08/17/2016
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