MEDICARE: MELISSA N LOJA MD

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	2086S0129X	Vascular Surgery Physician	A127991	CA

General Provider Information

NPI Number	:	1578826749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA N LOJA MD

Provider Business Mailing Address
First Line	:	1860 PENNSYLVANIA AVE STE 120
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94533-3550
Country	:	US
Telephone Number	:	707-646-4400
Fax Number	:	707-646-4461

Provider Business Practice Location Address
First Line	:	1860 PENNSYLVANIA AVE STE 120
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94533-3550
Country	:	US
Telephone Number	:	707-646-4400
Fax Number	:

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

Provider Enumeration Date	:	06/21/2012
Last Update Date	:	06/24/2021

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