MEDICARE: DR. MELANIE ELIZABETH HOAD DPT

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	225100000X	Physical Therapist	296543	CA

General Provider Information

NPI Number	:	1255956876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELANIE ELIZABETH HOAD DPT

Provider Business Mailing Address
First Line	:	7858 COWLES MOUNTAIN CT UNIT D11
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92119-2549
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7858 COWLES MOUNTAIN CT UNIT D11
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92119-2549
Country	:	US
Telephone Number	:	850-380-8559
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2020
Last Update Date	:	06/09/2020

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