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NPI Code Detail

MEDICARE: MELANIE DYAN JOHANSSON M.D.

MEDICARE: MELANIE DYAN JOHANSSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208VP0000XPain Medicine PhysicianC183026CA

General Provider Information

NPI Number : 1134417447
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELANIE DYAN JOHANSSON M.D.
Provider Business Mailing Address
First Line : 6939 SUNRISE BLVD STE 106
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 95610-3153
Country : US
Telephone Number : 916-352-7777
Fax Number : 877-354-4771
Provider Business Practice Location Address
First Line : 6939 SUNRISE BLVD STE 106
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 95610-3153
Country : US
Telephone Number : 916-352-7777
Fax Number : 877-354-4771
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2011
Last Update Date : 05/01/2025

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