Basic Information
| Provider Information | |||||||||
| NPI: | 1063863983 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SILLO | ||||||||
| FirstName: | MELODY | ||||||||
| MiddleName: | ORITSEMA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 935 MARKET ST | ||||||||
| Address2: | |||||||||
| City: | YUBA CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959914217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5306823765 | ||||||||
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| Practice Location | |||||||||
| Address1: | 334 SAMUEL DR | ||||||||
| Address2: | |||||||||
| City: | YUBA CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959916325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5306749200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2016 | ||||||||
| LastUpdateDate: | 08/05/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 267767 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | A168068 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.