Provider Demographics
NPI:1447350053
Name:MELAMED, HOOMAN MEIR (MD)
Entity type:Individual
Prefix:DR
First Name:HOOMAN
Middle Name:MEIR
Last Name:MELAMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 491518
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-9518
Mailing Address - Country:US
Mailing Address - Phone:310-595-5040
Mailing Address - Fax:310-574-0422
Practice Address - Street 1:9777 WILSHIRE BLVD STE 808
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-1908
Practice Address - Country:US
Practice Address - Phone:310-595-5040
Practice Address - Fax:310-574-0422
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85644174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI24014Medicare UPIN
CAWA85644BMedicare PIN
CAWA86544BMedicare PIN