Provider Demographics
NPI:1831565894
Name:SILVER, MELANIE (ATC)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:SILVER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2855 PINECREEK DR
Mailing Address - Street 2:#A-111
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-5400
Mailing Address - Country:US
Mailing Address - Phone:914-960-8807
Mailing Address - Fax:
Practice Address - Street 1:9401 WESTMINSTER AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-2901
Practice Address - Country:US
Practice Address - Phone:914-960-8807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-13
Last Update Date:2016-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer