Basic Information
Provider Information
NPI: 1013632025
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHULZ
FirstName: MELISSA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4073 KANSAS ST
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921042507
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 981 LOMAS SANTA FE DR
Address2:  
City: SOLANA BEACH
State: CA
PostalCode: 920752144
CountryCode: US
TelephoneNumber: 8587949995
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/12/2022
LastUpdateDate: 10/12/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/11/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X302663CAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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