Healthcare Provider Details

I. General information

NPI: 1932496551
Provider Name (Legal Business Name): MELISSA MARIA MUELLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2011
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N SEPULVEDA BLVD STE 100
MANHATTAN BEACH CA
90266-2735
US

IV. Provider business mailing address

5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 310-546-4599
  • Fax: 310-796-4941
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA117251
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA117251
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: