MEDICARE: MELANIE MARDEN UNLTD. LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC13391	CA

General Provider Information

NPI Number	:	1023458585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MELANIE MARDEN UNLTD. LLC

Provider Business Mailing Address
First Line	:	8491 W SUNSET BLVD
Second Line	:	#453
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90069-1911
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8491 W SUNSET BLVD
Second Line	:	#453
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90069-1911
Country	:	US
Telephone Number	:	877-870-4667
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. MELANIE MARDEN
Credential	:
Telephone Number	:	877-870-4667

Provider Enumeration Date	:	06/28/2013
Last Update Date	:	03/25/2014

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