Provider Demographics
NPI:1699209783
Name:CAMPBELL, MELISSA HIKARI-LUTTIO (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:HIKARI-LUTTIO
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6632 DARBY AVE
Mailing Address - Street 2:#9
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-5468
Mailing Address - Country:US
Mailing Address - Phone:561-702-2165
Mailing Address - Fax:
Practice Address - Street 1:6632 DARBY AVE
Practice Address - Street 2:#9
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-5468
Practice Address - Country:US
Practice Address - Phone:561-702-2165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-14
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program