Individual ProviderMonte Tim MellonEmergency MedicineAllopathic & Osteopathic PhysiciansPractice Address9888 Genesee Ave, La Jolla, CA 92037-1205(858) 626-6150(626) 447-0296PECOS EnrollmentBased on the most recent information from CMS, provider Monte Tim Mellon does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 1:00 PM.Profile DetailsProvider ID1033229927Provider TypeIndividualFull NameMellon, Monte TimTitleDr.CredentialM.D. M.B.A.GenderMaleSole ProprietorYesEnumeration Date8/30/2006Last Updated6/27/2008Contact InformationPractice LocationPractice Address9888 Genesee Ave, La Jolla, CA 92037-1205Phone(858) 626-6150Fax(858) 626-7117Mailing LocationMailing AddressPO Box 661687, Arcadia, CA 91066-1687Phone(626) 447-0296Fax(626) 447-6057Provider TaxonomiesCodeDescriptionLicenseCode207P00000XPrimaryDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicenseG46909CaliforniaProvider IdentifiersIDDescriptionIssuerID00G469090DescriptionMedicaidIssuerUnlistedCalifornia