MEDICARE: MESO SOLUTIONS, MD A PROFESSIONAL MEDICAL CORPORATION

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
1	302R00000X	Health Maintenance Organization	A33673	CA

General Provider Information

NPI Number	:	1477699338
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MESO SOLUTIONS, MD A PROFESSIONAL MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	14545 FRIAR STREET
Second Line	:	#104
City	:	VAN NUYS
State	:	CA
Zip	:	91411
Country	:	US
Telephone Number	:	818-908-9135
Fax Number	:	818-908-5983

Provider Business Practice Location Address
First Line	:	14545 FRIAR ST
Second Line	:	#104
City	:	VAN NUYS
State	:	CA
Zip	:	91411-2357
Country	:	US
Telephone Number	:	818-908-9135
Fax Number	:	818-908-5983

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. ALFREDO PASCALI
Credential	:	M.D
Telephone Number	:	818-908-9135

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	07/27/2007

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