Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | A52121 | CA |
NPI | 1063592269 |
---|---|
Provider Name | Dr. Carlos Roberto Meza |
First Address | Monterey Park, CA 91754-6340 |
Second Address | Monterey Park, CA 91754-6340 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 13/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A521210 | (05) | CA |
F51514 | (02) |