Marvin De Vera Melendez Jr., MSN; NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95006400 Issued in CA

Practice address

2031 Raymond Ave
Signal Hill, CA 90755-5930

Phone

(562) 253-5436

NPI assigned

Jun 15, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1760912240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 RAYMOND AVE",
            "city": "SIGNAL HILL",
            "state": "CA",
            "postal_code": "907555930",
            "telephone_number": "562-253-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 RAYMOND AVE",
            "city": "SIGNAL HILL",
            "state": "CA",
            "postal_code": "907555930",
            "telephone_number": "562-253-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELENDEZ",
        "first_name": "MARVIN",
        "middle_name": "DE VERA",
        "name_suffix": "Jr.",
        "credential": "MSN; NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenn R Matsushima, CPO, FAAOP
• Adam Mathew McAtee, PT, DPT
• Medicore Xy LLC
• Medilink Ty LLC
• Rebeca Meza Mejia, LMFT
• Stephanie Melvin
• Memorial Healthcare Ipa
• Memorial Healthcare Ipa GP C/O Independent Physician MGNT Servic
• Amanda Mena
• Leslie Amalia Mendoza, D.C.

• Family Nurse Practitioner in Signal Hill, CA
• Providers in Signal Hill, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.