Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A31428 | CA |
N | 111NI0900X | Internist | A31428 | CA |
N | 207RA0201X | Internist - Allergy & Immunology | A31428 | CA |
NPI | 1730104761 |
---|---|
Provider Name | Carlos E Meza |
First Address | Stockton, CA 95204-6032 |
Second Address | Stockton, CA 95204-6032 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A26475 | (02) | CA |