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NPI Code Detail

MEDICARE: MELISSA DAWN GONZALEZ LVN

MEDICARE:   MELISSA DAWN GONZALEZ  LVN
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
1164X00000XLicensed Vocational NurseVN158860CA

General Provider Information

NPI Number : 1548415656
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA DAWN GONZALEZ LVN
Provider Business Mailing Address
First Line : 2015 GENEVA STREET #47
Second Line :
City : OCEANSIDE
State : CA
Zip : 92054
Country : US
Telephone Number : 760-855-7798
Fax Number :
Provider Business Practice Location Address
First Line : 2015 GENEVA STREET #47
Second Line :
City : OCEANSIDE
State : CA
Zip : 92054
Country : US
Telephone Number : 760-855-7798
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2008
Last Update Date : 11/18/2008

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