Individual
MELANIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4570 GRIFFIN AVE, LOS ANGELES, CA 90031-1422
(323) 221-9174
Mailing address
4570 GRIFFIN AVE, LOS ANGELES, CA 90031-1422
(323) 221-9174
Taxonomy
Speciality
Code
Description
License number
State
374T00000X
Religious Nonmedical Nursing Personnel
Primary
—
—
376G00000X
Nursing Home Administrator
—
—
Other
Enumeration date
08/15/2012
Last updated
08/15/2012
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