Healthcare Provider Details

I. General information

NPI: 1518483460
Provider Name (Legal Business Name): LAUREN MEEPOS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8907 WILSHIRE BLVD STE 250
BEVERLY HILLS CA
90211-2014
US

IV. Provider business mailing address

13120 PONTOON PL
LOS ANGELES CA
90049-3634
US

V. Phone/Fax

Practice location:
  • Phone: 310-247-8687
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA160059
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: