Provider Demographics
NPI:1447334099
Name:MELVANI, ASHOK N (MD)
Entity type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:N
Last Name:MELVANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ASHOK
Other - Middle Name:N
Other - Last Name:MELVANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD INC
Mailing Address - Street 1:12677 HESPERIA RD
Mailing Address - Street 2:STE #140
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-7735
Mailing Address - Country:US
Mailing Address - Phone:760-962-1150
Mailing Address - Fax:760-962-1155
Practice Address - Street 1:12677 HESPERIA RD
Practice Address - Street 2:STE #140
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-7735
Practice Address - Country:US
Practice Address - Phone:760-962-1150
Practice Address - Fax:760-962-1155
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC43029207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C430290Medicaid
CA00C430290Medicaid
CA00C430290Medicaid
CABM3101324OtherDEPT OF DRUG ENFORCEMENT