Healthcare Provider Details

I. General information

NPI: 1700539582
Provider Name (Legal Business Name): MELODY ZIKO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2022
Last Update Date: 02/01/2022
Certification Date: 02/01/2022
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 StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: