Carlos Humberto Avila-Meljem, M.D.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

A79797 Issued in CA

Practice address

436 N Bedford Dr
Suite # 301
Beverly Hills, CA 90210-4310

Phone

(310) 285-0400

Fax

(310) 285-0222

NPI assigned

Jun 11, 2008

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1104086297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 N BEDFORD DR",
            "address_2": "SUITE # 301",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104310",
            "telephone_number": "310-285-0400",
            "fax_number": "310-285-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 N BEDFORD DR",
            "address_2": "SUITE # 301",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104310",
            "telephone_number": "310-285-0400",
            "fax_number": "310-285-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA-MELJEM",
        "first_name": "CARLOS",
        "middle_name": "HUMBERTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-11",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A79797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic and Reconstructive Surgery Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Plastic and Reconstructive Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.