MEDICARE: ROY A. MEALS, M.D., INC.

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	174400000X	Specialist	G40781	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710161088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROY A. MEALS, M.D., INC.

Provider Business Mailing Address
First Line	:	1033 GAYLEY AVE
Second Line	:	104
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-3417
Country	:	US
Telephone Number	:	310-824-1262
Fax Number	:	310-824-5190

Provider Business Practice Location Address
First Line	:	1033 GAYLEY AVE
Second Line	:	104
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-3417
Country	:	US
Telephone Number	:	310-824-1262
Fax Number	:	310-824-5190

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROY A MEALS
Credential	:	M.D.
Telephone Number	:	310-824-1262

Provider Enumeration Date	:	12/21/2007
Last Update Date	:	02/18/2015

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