| Doctor Name: | MELISSA MARIE DE LA O |
| NPI Number: | 1164602124 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | PT32233 |
| Business Practice Address: | 32261 Camino Capistrano Suite D101 San Juan Capistrano, CA - 926753746 |
| Business Phone Number: | 9494292155 |
| Business Fax Number: | 9494292151 |
| Mailing Address: | 32261 Camino Capistrano, Suite D101 SAN JUAN CAPISTRANO |
| State: | CA |
| Postal Code: | 926753746 |
| Phone Number: | 9494292155 |
| Fax Number: | 9494292151 |
| NPI Enumeration Date: | 11/07/2007 |
| NPI Last Update Date: | 10/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | PT32233 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |