Provider Demographics
NPI:1588687867
Name:HAKIM, MELINDA ASHRAT (MD)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:ASHRAT
Last Name:HAKIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8635 W 3RD STREET
Mailing Address - Street 2:#390W
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-6101
Mailing Address - Country:US
Mailing Address - Phone:310-652-1133
Mailing Address - Fax:310-652-4353
Practice Address - Street 1:8635 W 3RD STREET
Practice Address - Street 2:#390W
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-6101
Practice Address - Country:US
Practice Address - Phone:310-652-1133
Practice Address - Fax:310-652-4353
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83655207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A836550Medicaid
I41936Medicare UPIN
CAWA83655AMedicare ID - Type Unspecified