MEDICARE: MS. ANABELLE MYERS

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	246RM2200X	Medical Laboratory Technician

General Provider Information

NPI Number	:	1679949093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANABELLE MYERS

Provider Business Mailing Address
First Line	:	11671 STERLING AVE STE L
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92503-4971
Country	:	US
Telephone Number	:	951-346-5718
Fax Number	:

Provider Business Practice Location Address
First Line	:	1825 MADERA CIR
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92879-8210
Country	:	US
Telephone Number	:	714-856-5647
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2015
Last Update Date	:	08/19/2015

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