Provider Demographics
NPI:1184643801
Name:MCBRIDE, MELINDA (AUD)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:MCBRIDE
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:3734 SEPULVEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-2513
Mailing Address - Country:US
Mailing Address - Phone:310-375-6161
Mailing Address - Fax:310-375-6101
Practice Address - Street 1:2814 SEPULVEDA BLVD STE J
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-2863
Practice Address - Country:US
Practice Address - Phone:310-325-5004
Practice Address - Fax:310-325-1915
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU645235500000X, 237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW22057Medicare UPIN
CAWAU645CMedicare UPIN