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NPI Code Detail

MEDICARE: DR. MEGHAN J MARCUM PSYD

MEDICARE: DR. MEGHAN J MARCUM PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist

General Provider Information

NPI Number : 1467773770
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MEGHAN J MARCUM PSYD
Provider Business Mailing Address
First Line : 1 PARK PLZ STE 600
Second Line :
City : IRVINE
State : CA
Zip : 92614-5987
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1 PARK PLZ STE 600
Second Line :
City : IRVINE
State : CA
Zip : 92614-5987
Country : US
Telephone Number : 949-515-7300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2010
Last Update Date : 02/27/2012

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