Provider Demographics
NPI:1992113971
Name:BELGRAVE, MELINDA CHRISTELLE THEIRA (MD)
Entity type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:CHRISTELLE THEIRA
Last Name:BELGRAVE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1505 SHEPARD DR STE 102
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-7016
Mailing Address - Country:US
Mailing Address - Phone:805-928-9300
Mailing Address - Fax:805-928-9300
Practice Address - Street 1:301 S MILLER ST STE 204
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5244
Practice Address - Country:US
Practice Address - Phone:805-354-5200
Practice Address - Fax:805-354-5782
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA148826208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program