Provider Demographics
NPI:1689172207
Name:LOSCUTOV, MELANIE KAY (NP)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:KAY
Last Name:LOSCUTOV
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:20311 SW ACACIA ST STE 140
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1733
Mailing Address - Country:US
Mailing Address - Phone:949-891-1441
Mailing Address - Fax:949-474-7734
Practice Address - Street 1:20311 SW ACACIA ST STE 140
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1733
Practice Address - Country:US
Practice Address - Phone:949-891-1441
Practice Address - Fax:949-878-4845
Is Sole Proprietor?:No
Enumeration Date:2018-01-29
Last Update Date:2023-05-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA429671363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics