Healthcare Provider Details

I. General information

NPI: 1942006309
Provider Name (Legal Business Name): MELANIE GARDEA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 W METROPOLITAN DR STE 405
ORANGE CA
92868-3504
US

IV. Provider business mailing address

8226 BUHMAN AVE
PICO RIVERA CA
90660-5202
US

V. Phone/Fax

Practice location:
  • Phone: 714-834-2191
  • Fax:
Mailing address:
  • Phone: 562-712-4301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: