Healthcare Provider Details

I. General information

NPI: 1861630204
Provider Name (Legal Business Name): MELZER CHIROPRACTIC GROUP, APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2009
Last Update Date: 01/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 W 7TH ST
SAN PEDRO CA
90731-3118
US

IV. Provider business mailing address

1536 W 25TH ST # 543
SAN PEDRO CA
90732-4415
US

V. Phone/Fax

Practice location:
  • Phone: 310-832-4476
  • Fax: 310-832-7034
Mailing address:
  • Phone: 310-832-4476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC21059
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberDC21059
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberDC21059
License Number StateCA

VIII. Authorized Official

Name: DR. ERIC WILLIAM MELZER
Title or Position: CEO/OWNER
Credential: D.C.
Phone: 310-832-4476