Provider Demographics
NPI:1851482327
Name:REIFLER, MELODY LORRAINE (LAC)
Entity Type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:LORRAINE
Last Name:REIFLER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:DR
Other - First Name:MELODY
Other - Middle Name:LORRAINE
Other - Last Name:SAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DAOM
Mailing Address - Street 1:1610 POST ST STE 305
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3600
Mailing Address - Country:US
Mailing Address - Phone:415-350-2343
Mailing Address - Fax:415-292-4737
Practice Address - Street 1:1610 POST ST STE 305
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3600
Practice Address - Country:US
Practice Address - Phone:415-350-2343
Practice Address - Fax:415-292-4737
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10540171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC0104500OtherMEDI-CAL PROVIDER NUMBER