Provider Demographics
NPI:1225106743
Name:GISLER, MELANIE ANN (DO)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:ANN
Last Name:GISLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:SCHARFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3330 INGLEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-1928
Mailing Address - Country:US
Mailing Address - Phone:310-391-0818
Mailing Address - Fax:
Practice Address - Street 1:13040 15TH STREET
Practice Address - Street 2:202
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404
Practice Address - Country:US
Practice Address - Phone:310-393-0739
Practice Address - Fax:310-395-2063
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2OA9176207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine