Provider Demographics
NPI:1295100170
Name:PAMINTUAN, MELANIE (MPT)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:PAMINTUAN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8052 ANDRE LN
Mailing Address - Street 2:
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-2028
Mailing Address - Country:US
Mailing Address - Phone:714-507-0065
Mailing Address - Fax:
Practice Address - Street 1:8052 ANDRE LN
Practice Address - Street 2:
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-2028
Practice Address - Country:US
Practice Address - Phone:714-507-0065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-03
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20169225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist