MEDICARE: MELISSA G ROSSI PA

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	363A00000X	Physician Assistant	PA17852	CA

General Provider Information

NPI Number	:	1881878247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA G ROSSI PA

Provider Business Mailing Address
First Line	:	1611 CREEKSIDE DR STE 102
Second Line	:
City	:	FOLSOM
State	:	CA
Zip	:	95630-3490
Country	:	US
Telephone Number	:	916-984-9004
Fax Number	:

Provider Business Practice Location Address
First Line	:	1611 CREEKSIDE DR STE 102
Second Line	:	SUITE 602
City	:	FOLSOM
State	:	CA
Zip	:	95630-3490
Country	:	US
Telephone Number	:	916-984-9004
Fax Number	:

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

Provider Enumeration Date	:	12/20/2007
Last Update Date	:	08/01/2011

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