Healthcare Provider Details

I. General information

NPI: 1881558351
Provider Name (Legal Business Name): MEGAN MA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3610 LONG BEACH BLVD STE 202
LONG BEACH CA
90807-4091
US

IV. Provider business mailing address

3610 LONG BEACH BLVD STE 202
LONG BEACH CA
90807-4091
US

V. Phone/Fax

Practice location:
  • Phone: 562-427-8119
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: