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General NPI Number Information
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NPI Number | 1043579626
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Entity Type | Individual
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Provider Name | MELISSA KO D.C.
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Gender | Female
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Dates
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Enumeration Date | 05/16/2012
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Last Update Date | 08/03/2012
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Provider Practice Location Address
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Address Line | 1888 SARATOGA AVE STE 101
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City | SAN JOSE
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State | CA
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Zip | 95129-5214
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Country | US
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Telephone | 925-984-1850
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Fax |
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Provider Business Mailing Address
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Address Line | 2311 GOLDENROD LN
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City | SAN RAMON
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State | CA
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Zip | 94582-5546
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 32293
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License Number State | CA
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