Melinda Ann Longaker, MD

Primary specialty

Clinical & Laboratory Dermatological Immunology PhysicianTaxonomy code 207NI0002X

License

0G63392 Issued in CA

Practice address

1225 Crane Street
Ste 102
Menlo Park, CA 94025

Phone

(650) 323-0276

Fax

(650) 323-8540

NPI assigned

Sep 28, 2006

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

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.

• Crane Street Dermatology

  • Dermatology Physician
  • Menlo Park, CA
  • NPI 1801293154
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902997430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 CRANE STREET",
            "address_2": "STE 102",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "94025",
            "telephone_number": "650-323-0276",
            "fax_number": "650-323-8540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 CRANE STREET",
            "address_2": "STE 102",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "94025",
            "telephone_number": "650-323-0276",
            "fax_number": "650-323-8540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGAKER",
        "first_name": "MELINDA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NI0002X",
            "taxonomy_group": "",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "CA",
            "license": "0G63392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robie Grove Livingstone, MPT
• Theresa Lo, M.D.
• Dorene Loew, PH.D.
• Michelle A Loftis, MD
• Gabriel Angelo Lonero, MSW
• Longs Drug Stores California LLC
• Martha S Losch, M.D.
• Gabrielle Lou, PSYD
• Dexter Louie
• Lovina Chahal MD PC

• All providers in Menlo Park, CA
• Clinical & Laboratory Dermatological Immunology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.