Provider Demographics
NPI:1306836994
Name:ALCANTARA, MELODIA V (NP)
Entity Type:Individual
Prefix:
First Name:MELODIA
Middle Name:V
Last Name:ALCANTARA
Suffix:
Gender:F
Credentials:NP
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 E CESAR E CHAVEZ AVE
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-2424
Mailing Address - Country:US
Mailing Address - Phone:323-268-2200
Mailing Address - Fax:323-268-2212
Practice Address - Street 1:1700 E CESAR E CHAVEZ AVE
Practice Address - Street 2:SUITE 1200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-2424
Practice Address - Country:US
Practice Address - Phone:323-268-2200
Practice Address - Fax:323-268-2212
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2021-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA15236363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily