MEDICARE: MELODIA V. ALCANTARA N.P.

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	363LF0000X	Family Nurse Practitioner	15236	CA

General Provider Information

NPI Number	:	1306836994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELODIA V. ALCANTARA N.P.

Provider Business Mailing Address
First Line	:	1700 E CESAR E CHAVEZ AVE
Second Line	:	SUITE 1200
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-2424
Country	:	US
Telephone Number	:	323-268-2200
Fax Number	:	323-268-2212

Provider Business Practice Location Address
First Line	:	1700 E CESAR E CHAVEZ AVE
Second Line	:	SUITE 1200
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-2424
Country	:	US
Telephone Number	:	323-268-2200
Fax Number	:	323-268-2212

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	10/24/2021

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