Provider Demographics
NPI:1548332125
Name:PARENT, MELONY B (MD)
Entity type:Individual
Prefix:
First Name:MELONY
Middle Name:B
Last Name:PARENT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5333 HOLLISTER AVE
Mailing Address - Street 2:SUITE #210
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2341
Mailing Address - Country:US
Mailing Address - Phone:805-964-9886
Mailing Address - Fax:805-964-6067
Practice Address - Street 1:5333 HOLLISTER AVE
Practice Address - Street 2:SUITE #210
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2341
Practice Address - Country:US
Practice Address - Phone:805-964-9886
Practice Address - Fax:805-964-6067
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG71816207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF47058Medicare UPIN
CAG71816Medicare PIN