Healthcare Provider Details

I. General information

NPI: 1013662188
Provider Name (Legal Business Name): MELODY MEDIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 02/17/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 N SIERRA BONITA AVE APT 118
WEST HOLLYWOOD CA
90046-4189
US

IV. Provider business mailing address

1320 N SIERRA BONITA AVE APT 118
WEST HOLLYWOOD CA
90046-4189
US

V. Phone/Fax

Practice location:
  • Phone: 424-222-4200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State

VIII. Authorized Official

Name: MELODY ZIKO
Title or Position: CEO/OWNER
Credential:
Phone: 424-222-4200