Basic Information
| Provider Information | |||||||||
| NPI: | 1033388269 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PECK | ||||||||
| FirstName: | MELICENT | ||||||||
| MiddleName: | CLARE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | M.D., PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 513 PARNASSUS AVE | ||||||||
| Address2: | S-380, BOX 0654 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941430654 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154769362 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 513 PARNASSUS AVE | ||||||||
| Address2: | S-380, BOX 0654 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941430654 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154769362 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2008 | ||||||||
| LastUpdateDate: | 05/14/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | A105023 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.