Provider Demographics
NPI:1043092695
Name:MORENO, MELINDA (PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:MORENO
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:
Other - Last Name:ZUNIGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6346 RITA AVE APT F
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-4185
Mailing Address - Country:US
Mailing Address - Phone:323-719-6112
Mailing Address - Fax:
Practice Address - Street 1:6346 RITA AVE APT F
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-4185
Practice Address - Country:US
Practice Address - Phone:323-719-6112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty