Healthcare Provider Details

I. General information

NPI: 1891731832
Provider Name (Legal Business Name): CHRISTOPHER J MEOLI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 02/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35800 BOB HOPE DR INTERVENTIONAL RADIOLOGY AND IMAGING CENTER, SUITE 150
RANCHO MIRAGE CA
92270-1739
US

IV. Provider business mailing address

35800 BOB HOPE DR INTERVENTIONAL RADIOLOGY AND IMAGING CENTER, SUITE 150
RANCHO MIRAGE CA
92270-1739
US

V. Phone/Fax

Practice location:
  • Phone: 760-770-1920
  • Fax: 760-324-0848
Mailing address:
  • Phone: 760-770-1920
  • Fax: 760-324-0848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number34435
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number20A 10654
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number20A 10654
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: