Organization
DR MELISSA PONCE- FUNCTIONAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA PONCE DC (OWNER)
(909) 260-2181
Entity
Organization
Contact information
Practice address
654 N EL CAMINO REAL, STE. 101, SAN MATEO, CA 94401-3713
(650) 242-9202
Mailing address
654 N EL CAMINO REAL, STE. 101, SAN MATEO, CA 94401-3713
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
DC31510
CA
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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