Healthcare Provider Details

I. General information

NPI: 1275124448
Provider Name (Legal Business Name): MELISSA A KUHN-HARVEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2021
Last Update Date: 02/01/2021
Certification Date: 02/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W. AVE J
LANCASTER CA
93534
US

IV. Provider business mailing address

PO BOX 1552
WRIGHTWOOD CA
92397
US

V. Phone/Fax

Practice location:
  • Phone: 909-841-2965
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number159788
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number196499
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: