Provider Demographics
NPI:1487723953
Name:MELZER, WILLIAM EDWARD (OD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EDWARD
Last Name:MELZER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6133 BRISTOL PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6609
Mailing Address - Country:US
Mailing Address - Phone:310-641-8000
Mailing Address - Fax:310-641-8089
Practice Address - Street 1:6133 BRISTOL PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6609
Practice Address - Country:US
Practice Address - Phone:310-641-8000
Practice Address - Fax:310-641-8089
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA6511T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GX462AOtherMEDICARE PTAN
CAGX462AMedicare PIN