Provider Demographics
NPI:1942257373
Name:BUSH, MELISSA CARYN (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:CARYN
Last Name:BUSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:24411 HEALTH CENTER DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3633
Mailing Address - Country:US
Mailing Address - Phone:949-452-7199
Mailing Address - Fax:949-452-7333
Practice Address - Street 1:24411 HEALTH CENTER DR
Practice Address - Street 2:SUITE 300
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3633
Practice Address - Country:US
Practice Address - Phone:949-452-7199
Practice Address - Fax:949-452-7333
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA65241207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine