Healthcare Provider Details

I. General information

NPI: 1386079481
Provider Name (Legal Business Name): MELISSA SCHWARTZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2013
Last Update Date: 08/04/2023
Certification Date: 08/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5251 VIEWRIDGE CT
SAN DIEGO CA
92123
US

IV. Provider business mailing address

5251 VIEWRIDGE CT
SAN DIEGO CA
92123
US

V. Phone/Fax

Practice location:
  • Phone: 858-266-6900
  • Fax:
Mailing address:
  • Phone: 858-266-6900
  • Fax: 314-781-2840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number2019016081
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: