MEDICARE: MS. MELISSA LYNN ZIEHL MPT

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	21575	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	21575	OTHER	CA	PT LICENSE

General Provider Information

NPI Number	:	1386857225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELISSA LYNN ZIEHL MPT

Provider Business Mailing Address
First Line	:	104 S FRANCISCA AVE UNIT C
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-3312
Country	:	US
Telephone Number	:	310-895-0204
Fax Number	:

Provider Business Practice Location Address
First Line	:	5151 MURPHY CANYON RD STE 150
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-4339
Country	:	US
Telephone Number	:	800-458-7777
Fax Number	:	800-863-2978

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

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	07/08/2007

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