Healthcare Provider Details

I. General information

NPI: 1659778801
Provider Name (Legal Business Name): MELODY ANNE CALA NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2014
Last Update Date: 12/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2051 MARENGO ST
LOS ANGELES CA
90033-1352
US

IV. Provider business mailing address

1121 S LARK ELLEN AVE
WEST COVINA CA
91791-3530
US

V. Phone/Fax

Practice location:
  • Phone: 323-409-7811
  • Fax:
Mailing address:
  • Phone: 213-804-1073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95001755
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: