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NPI Code Detail

MEDICARE: ERIC MELCER DPT

MEDICARE: ERIC MELCER DPT
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
1174400000XSpecialist
2225100000XPhysical Therapist299967CA

General Provider Information

NPI Number : 1679176085
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC MELCER DPT
Provider Business Mailing Address
First Line : 11460 W WASHINGTON BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-6030
Country : US
Telephone Number : 310-659-9511
Fax Number :
Provider Business Practice Location Address
First Line : 11460 W WASHINGTON BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-6030
Country : US
Telephone Number : 310-659-9511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2020
Last Update Date : 11/30/2021

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