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Individual

DR. KURT ALLAN MELSTROM JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
412 W CARROLL AVE STE 200, GLENDORA, CA 91741-4709
(626) 914-3921
(626) 963-0500
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036114508
IL
208600000X
Surgery Physician
259161
NY
208600000X
Surgery Physician
A135013
CA
208C00000X
Colon & Rectal Surgery Physician
Primary
A135013
CA

Other

Enumeration date
06/10/2008
Last updated
11/17/2020
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