MEDICARE: MELISSA MARINO

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	183500000X	Pharmacist	51026	CA

General Provider Information

NPI Number	:	1730261660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA MARINO

Provider Business Mailing Address
First Line	:	8351 WOODLAKE AVE
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91304-3138
Country	:	US
Telephone Number	:	818-719-4050
Fax Number	:

Provider Business Practice Location Address
First Line	:	5601 DESOTO AVE
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91365
Country	:	US
Telephone Number	:	818-719-4050
Fax Number	:

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

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	08/08/2007

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Directions to “ MELISSA MARINO ” Practice Location

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