Individual
JOSEPH ANDREW MELLEN IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 673-3594
Mailing address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 673-3594
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
207L00000X
Anesthesiology Physician
Primary
0101281044
VA
208D00000X
General Practice Physician
Primary
101281044
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2022
Last updated
07/27/2026
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