Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 33340 | CA |
NPI | 1043552920 |
---|---|
Provider Name | James Martin Meeks |
First Address | Ladera Ranch, CA 92694-1152 |
Second Address | Ladera Ranch, CA 92694-1152 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2013 |
Last Update Date | 19/03/2013 |