Provider Demographics
NPI:1053399535
Name:GORELICK, MELVIN FRONS (MD)
Entity type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:FRONS
Last Name:GORELICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:261 EL DORADO ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2911
Mailing Address - Country:US
Mailing Address - Phone:831-649-1811
Mailing Address - Fax:831-649-1817
Practice Address - Street 1:261 EL DORADO ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2911
Practice Address - Country:US
Practice Address - Phone:831-649-1811
Practice Address - Fax:831-649-1817
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG16824207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G168240Medicare ID - Type UnspecifiedLICENSE
A39921Medicare UPIN