Basic Information
| Provider Information | |||||||||
| NPI: | 1568946218 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAMOS | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | NADINE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4862 OLINDA ST | ||||||||
| Address2: | |||||||||
| City: | YORBA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928863438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145722272 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1988 HACIENDA DR | ||||||||
| Address2: | |||||||||
| City: | VISTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920816026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7602952625 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2018 | ||||||||
| LastUpdateDate: | 03/26/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 79001 | CA | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.