Provider Demographics
NPI:1720321755
Name:NARDI, MELISSA ANN (DO)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:ANN
Last Name:NARDI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:4077 FIFTH AVE
Mailing Address - Street 2:MER 127
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103
Mailing Address - Country:US
Mailing Address - Phone:619-294-8111
Mailing Address - Fax:619-686-3440
Practice Address - Street 1:4077 FIFTH AVE
Practice Address - Street 2:MER 127
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103
Practice Address - Country:US
Practice Address - Phone:619-924-8111
Practice Address - Fax:619-686-3440
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A13524207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine