Healthcare Provider Details

I. General information

NPI: 1477921492
Provider Name (Legal Business Name): MEYERS MEDICAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2015
Last Update Date: 09/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3740 ATLANTIC AVE SUITE 100
LONG BEACH CA
90807-3440
US

IV. Provider business mailing address

3740 ATLANTIC AVE SUITE 100
LONG BEACH CA
90807-3440
US

V. Phone/Fax

Practice location:
  • Phone: 562-490-3740
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH S MEYERS
Title or Position: OWNER
Credential: MD
Phone: 562-490-3740