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General NPI Number Information
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NPI Number | 1154627362
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Entity Type | Individual
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Provider Name | AMAIYA MELISSA THOMPSON PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/04/2011
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 8767 WILSHIRE BLVD FL 2
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2714
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Country | US
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Telephone | 310-248-7000
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Fax | 310-248-7033
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Provider Business Mailing Address
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Address Line | 1820 W ORANGEWOOD AVE STE 105
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City | ORANGE
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State | CA
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Zip | 92868-5052
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Country | US
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Telephone | 703-310-9495
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 58134
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA58134
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License Number State | CA
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