Healthcare Provider Details

I. General information

NPI: 1083849475
Provider Name (Legal Business Name): RICHARD HAROLD MESCO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2009
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1560 E CHEVY CHASE DR STE 130
GLENDALE CA
91206-4140
US

IV. Provider business mailing address

1560 E CHEVY CHASE DR STE 130
GLENDALE CA
91206-4140
US

V. Phone/Fax

Practice location:
  • Phone: 818-240-0340
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number20A5682
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number20A5682
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: