Healthcare Provider Details

I. General information

NPI: 1366078743
Provider Name (Legal Business Name): RHONDA J. MYERS, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2020
Last Update Date: 05/04/2020
Certification Date: 05/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4902 IRVINE CENTER DR STE 108
IRVINE CA
92604-3334
US

IV. Provider business mailing address

4902 IRVINE CENTER DR STE 108
IRVINE CA
92604-3334
US

V. Phone/Fax

Practice location:
  • Phone: 949-552-3121
  • Fax: 949-552-3723
Mailing address:
  • Phone: 949-552-3121
  • Fax: 949-552-3723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: CECILE TOLENTINO
Title or Position: BILLING/FRONT OFFICE
Credential:
Phone: 949-552-3121