Healthcare Provider Details

I. General information

NPI: 1669483590
Provider Name (Legal Business Name): METHUSA JAVINAR MEJIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35800 BOB HOPE DR STE 220
RANCHO MIRAGE CA
92270-1739
US

IV. Provider business mailing address

35800 BOB HOPE DR STE 220
RANCHO MIRAGE CA
92270-1739
US

V. Phone/Fax

Practice location:
  • Phone: 760-464-0561
  • Fax: 760-464-0562
Mailing address:
  • Phone: 760-464-0561
  • Fax: 760-464-0562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA740580
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: