Provider Demographics
NPI:1922297829
Name:NAGARE, MELISSA ANNE (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:ANNE
Last Name:NAGARE
Suffix:
Gender:F
Credentials:DC, LAC
Other - Prefix:DR
Other - First Name:MELISSA
Other - Middle Name:NAGARE
Other - Last Name:KIMURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC, LAC
Mailing Address - Street 1:16200 AMBER VALLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-4051
Mailing Address - Country:US
Mailing Address - Phone:562-947-3386
Mailing Address - Fax:562-902-3350
Practice Address - Street 1:16200 AMBER VALLEY DR
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90604-4051
Practice Address - Country:US
Practice Address - Phone:562-947-3386
Practice Address - Fax:562-902-3350
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11936171100000X
CA30706111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist