Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 35672 | AZ |
Y | 204F00000X | Transplant Surgeon | C54096 | CA |
N | 208200000X | Surgeon | ME90794 | FL |
N | 208600000X | Surgeon | ME90794 | FL |
NPI | 1104861947 |
---|---|
Provider Name | Dr. Kristin L Mekeel |
First Address | San Diego, CA 92103-8401 |
Second Address | San Diego, CA 92103-8401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 19/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
115142 | (05) | AZ |
270663600 | (05) | FL |
860800150 85054 D001 | TRICARE (01) | AZ |
I16845 | (02) | |
P00625149 | RAILROAD MEDICARE (01) | AZ |