MEDICARE: MELINDA YLAUAN RN

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	163WC1500X	Community Health Registered Nurse	95090585	CA

General Provider Information

NPI Number	:	1366031429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELINDA YLAUAN RN

Provider Business Mailing Address
First Line	:	2520 CANADA BLVD
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91208-2029
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2520 CANADA BLVD
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91208-2029
Country	:	US
Telephone Number	:	310-291-2017
Fax Number	:

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

Provider Enumeration Date	:	01/13/2021
Last Update Date	:	01/13/2021

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