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General NPI Number Information
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NPI Number | 1881415537
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Entity Type | Individual
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Provider Name | MELISSA DUARTE FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/24/2024
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Last Update Date | 12/21/2024
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Provider Practice Location Address
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Address Line | 3450 WILSHIRE BLVD STE 1118
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City | LOS ANGELES
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State | CA
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Zip | 90010-2227
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Country | US
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Telephone | 213-465-2643
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Fax | 213-232-4944
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Provider Business Mailing Address
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Address Line | 517 W 159TH PL
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City | GARDENA
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State | CA
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Zip | 90248-2413
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Country | US
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Telephone | 323-702-7949
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95033154
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License Number State | CA
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