MEDICARE: SARAH MELZER NP

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
1	363LF0000X	Family Nurse Practitioner	NP95014703	CA

General Provider Information

NPI Number	:	1285252544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MELZER NP

Provider Business Mailing Address
First Line	:	4097 PINE HOLLOW PL
Second Line	:
City	:	MOORPARK
State	:	CA
Zip	:	93021-3122
Country	:	US
Telephone Number	:	858-472-9446
Fax Number	:

Provider Business Practice Location Address
First Line	:	299 W HILLCREST DR STE 100
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-7820
Country	:	US
Telephone Number	:	805-497-7888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2020
Last Update Date	:	08/11/2020

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