Monte Tim Mellon, M.D. M.B.A.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

G46909 Issued in CA

Practice address

9888 Genesee Ave
La Jolla, CA 92037-1205

Phone

(858) 626-6150

Fax

(858) 626-7117

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration, Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Edwin Iliff, M.D.,Inc.

  dba La Jolla Emergency Physician's Medical Group

  • Emergency Medicine Physician
  • La Jolla, CA
  • NPI 1588694855
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1033229927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 661687",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910661687",
            "telephone_number": "626-447-0296",
            "fax_number": "626-447-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9888 GENESEE AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371205",
            "telephone_number": "858-626-6150",
            "fax_number": "858-626-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLON",
        "first_name": "MONTE",
        "middle_name": "TIM",
        "name_prefix": "Dr.",
        "credential": "M.D. M.B.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G46909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G469090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Antonie Meixel, M.D.
• Melanie a. Farrell, M.D., a Professional Medical Corporation
• Martine Melillo
• Melissa Minger DMD Inc (Seaside Dental)
• Loren K. Mell, M.D.
• Melvin L. Selzer, MD, Inc
• Christian W Mende, MD
• Dana L. Mendel, PH. D.
• George Stuart Mendenhall, MD
• Kristina Mendez, PH.D.

• Emergency Medicine Physician in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.