Healthcare Provider Details

I. General information

NPI: 1003067331
Provider Name (Legal Business Name): MEERA DHIRUBHAI KANANI D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2008
Last Update Date: 12/01/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 N MISSION RD
LOS ANGELES CA
90033-1019
US

IV. Provider business mailing address

1116 ARCADIA AVE UNIT 4
ARCADIA CA
91007-7005
US

V. Phone/Fax

Practice location:
  • Phone: 323-226-3691
  • Fax:
Mailing address:
  • Phone: 626-826-1017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20A10244
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: