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General NPI Number Information
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NPI Number | 1437048949
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Entity Type | Individual
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Provider Name | MELISSA RITA SUTOYO NP
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Gender | Female
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 624 W DUARTE RD STE 208
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City | ARCADIA
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State | CA
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Zip | 91007-7675
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Country | US
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Telephone | 626-294-9978
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Fax |
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Provider Business Mailing Address
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Address Line | 624 W DUARTE RD STE 208
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City | ARCADIA
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State | CA
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Zip | 91007-7675
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Country | US
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Telephone | 626-294-9978
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 95035639
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 95035639
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 95035639
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License Number State | CA
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