MEDICARE: MESHARI ALHARTHI

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	390200000X	Student in an Organized Health Care Education/Training Program
2	2084N0400X	Neurology Physician	PTL5273	CA

General Provider Information

NPI Number	:	1952920217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MESHARI ALHARTHI

Provider Business Mailing Address
First Line	:	200 W ARBOR DR # 8465
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-1911
Country	:	US
Telephone Number	:	619-543-6291
Fax Number	:	619-543-5793

Provider Business Practice Location Address
First Line	:	200 W ARBOR DR # 8465
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-1911
Country	:	US
Telephone Number	:	619-543-6291
Fax Number	:	619-543-5793

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

Provider Enumeration Date	:	04/15/2020
Last Update Date	:	08/05/2021

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Directions to “ MESHARI ALHARTHI ” Practice Location

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