Organization Active NPI

Clifford Ralph Melton

  • Urology Physician
  • Oakland, CA
National Provider Identifier
1417043233
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A35741 Issued in CA
Legal business name
CLIFFORD RALPH MELTON
Practice address
401 29TH St
206
Oakland, CA 94609
Phone
(510) 835-3680
Fax
(510) 835-0738
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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

Authorized official

Name
Clifford Ralph Melton, MD
Title
Pres Owner
Phone
(510) 835-3680

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X A35741 CA Primary

Addresses

Primary practice location

401 29TH St
206
Oakland, CA 94609

Mailing address

401 29TH St
206
Oakland, CA 94609
Phone (510) 835-3680

Other identifiers 1

IdentifierTypeStateIssuer
00A357410MedicaidCA

National Provider Directory

National Provider Directory

Locations

401 29th St
#206
Oakland, CA 94609
Phone (510) 835-3680

401 29th St
Ste 206
Oakland, CA 94609
Phone (415) 835-3680

411 30th St
Ste 520
Oakland, CA 94609
Phone (310) 893-8651

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1417043233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 29TH ST",
            "address_2": "206",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94609",
            "telephone_number": "510-835-3680",
            "fax_number": "510-835-0738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 29TH ST",
            "address_2": "206",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94609",
            "telephone_number": "510-835-3680",
            "fax_number": "510-835-0738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFFORD RALPH MELTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "MELTON",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_middle_name": "RALPH",
        "authorized_official_title_or_position": "PRES OWNER",
        "authorized_official_telephone_number": "510-835-3680",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "A35741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A357410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

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