Basic Information
Provider Information
NPI: 1174027890
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CURL
FirstName: MELODY
MiddleName: APRIL
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1485 SARATOGA AVE STE 200
Address2:  
City: SAN JOSE
State: CA
PostalCode: 951294965
CountryCode: US
TelephoneNumber: 8779910009
FaxNumber: 8772079553
Practice Location
Address1: 1485 SARATOGA AVE STE 200
Address2:  
City: SAN JOSE
State: CA
PostalCode: 951294965
CountryCode: US
TelephoneNumber: 8779910009
FaxNumber: 8772079553
Other Information
ProviderEnumerationDate: 03/19/2018
LastUpdateDate: 03/19/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106S00000X  Y    

No ID Information.


Home