Provider Demographics
NPI:1447335294
Name:MELLIN, STAN (DC)
Entity type:Individual
Prefix:DR
First Name:STAN
Middle Name:
Last Name:MELLIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CAMINO AGUAJITO
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-3372
Mailing Address - Country:US
Mailing Address - Phone:831-375-2410
Mailing Address - Fax:831-375-2278
Practice Address - Street 1:200 CAMINO AGUAJITO
Practice Address - Street 2:SUITE 201
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3372
Practice Address - Country:US
Practice Address - Phone:831-375-2410
Practice Address - Fax:831-375-2278
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16630111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor