Provider Demographics
NPI:1437306016
Name:O'DONNELL, MELODY MICHELE (RD)
Entity type:Individual
Prefix:
First Name:MELODY
Middle Name:MICHELE
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 PARNASSUS AVE
Mailing Address - Street 2:M-294
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0212
Mailing Address - Country:US
Mailing Address - Phone:415-353-2788
Mailing Address - Fax:415-353-8703
Practice Address - Street 1:505 PARNASSUS AVE
Practice Address - Street 2:M-294
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0212
Practice Address - Country:US
Practice Address - Phone:415-353-2788
Practice Address - Fax:415-353-8703
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered