Individual
DR. GREGORY WAYNE MELLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
590 W PUTNAM AVE, #2B, PORTERVILLE, CA 93257-3257
(559) 782-1973
(559) 782-1976
Mailing address
590 W PUTNAM AVE, #2B, PORTERVILLE, CA 93257-3257
(559) 782-1973
(559) 782-1976
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G40981
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G409810
—
CA
05
—
00G409811
—
CA
Enumeration date
11/15/2006
Last updated
07/08/2007
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