Individual provider · NPI-1

Reed Grant Mellor, MD

Pediatrics · Stockton, CA

NPI number1881687465
StatusActive
Last updated in NPPESJan 10, 2022

Details

NPI
1881687465
Entity type
Individual (NPI-1)
Name
Reed Grant Mellor
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Aug 29, 2005
Last updated
Jan 10, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208000000X Pediatrics34996IAYes
2080A0000X Pediatrics, Adolescent MedicineA97111CA

Other names

  • Reed Grant Mellor (Other Name)

Practice location

7373 West Ln
Stockton, CA 95210-3377

Phone 209-476-3094

Mailing address

7373 West Ln
Stockton, CA 95210-3377

Phone 209-476-3094

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