Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | A52845 | CA |
NPI | 1043235476 |
---|---|
Provider Name | Arthur Meza |
First Address | Chula Vista, CA 91911-6963 |
Second Address | Chula Vista, CA 91911-6963 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G13638 | (02) | CA |