Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | A151395 | CA |
N | 207RA0401X | Internist - Addiction Medicine | A151395 | CA |
NPI | 1649666470 |
---|---|
Provider Name | Julio Meza |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Santa Monica, CA 90404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2015 |
Last Update Date | 02/12/2019 |