Healthcare Provider Details

I. General information

NPI: 1548457435
Provider Name (Legal Business Name): MELISSA LYDIA BURLA MSN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 09/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W. CARSON ST
TORRANCE CA
90509
US

IV. Provider business mailing address

8060 COWAN AVE
WESTCHESTER CA
90045-1405
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-4038
  • Fax: 310-533-4043
Mailing address:
  • Phone:
  • Fax: 310-533-4043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number474849
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: