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NPI Code Detail

MEDICARE: DR. IVAN DENNIS MEADOWS M.D.

MEDICARE:  DR. IVAN DENNIS MEADOWS  M.D.
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
1207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianG66117CA

General Provider Information

NPI Number : 1801878848
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IVAN DENNIS MEADOWS M.D.
Provider Business Mailing Address
First Line : 5253 SPRINGRIDGE WAY
Second Line :
City : FAIRFIELD
State : CA
Zip : 94534-4009
Country : US
Telephone Number : 707-864-5909
Fax Number :
Provider Business Practice Location Address
First Line : 150 MUIR RD
Second Line :
City : MARTINEZ
State : CA
Zip : 94553-4668
Country : US
Telephone Number : 925-372-2140
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2005
Last Update Date : 07/08/2007

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Directions to “ DR. IVAN DENNIS MEADOWS M.D.” Practice Location

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