MEDICARE: MELISSA ANN HINOJOSA LMT

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	225700000X	Massage Therapist	73482	CA

General Provider Information

NPI Number	:	1558843094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA ANN HINOJOSA LMT

Provider Business Mailing Address
First Line	:	7860 MISSION CENTER CT STE 209
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1331
Country	:	US
Telephone Number	:	619-633-4003
Fax Number	:

Provider Business Practice Location Address
First Line	:	7860 MISSION CENTER CT STE 209
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1331
Country	:	US
Telephone Number	:	619-633-4003
Fax Number	:

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

Provider Enumeration Date	:	08/31/2018
Last Update Date	:	08/31/2018

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