Provider Demographics
NPI:1891878740
Name:GORALKA, MELISSA (PA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:GORALKA
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:3687 MT. DIABLO BLVD,
Mailing Address - Street 2:STE 200
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549
Mailing Address - Country:US
Mailing Address - Phone:925-962-6600
Mailing Address - Fax:925-284-5662
Practice Address - Street 1:20130 LAKE CHABOT BLVD,
Practice Address - Street 2:STE 201
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546
Practice Address - Country:US
Practice Address - Phone:510-204-2351
Practice Address - Fax:510-886-8531
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2011-11-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA13050363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant