Healthcare Provider Details

I. General information

NPI: 1962502773
Provider Name (Legal Business Name): MENG HUA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 12/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6699 ALVARADO RD STE 2306
SAN DIEGO CA
92120-5241
US

IV. Provider business mailing address

6699 ALVARADO RD STE 2306
SAN DIEGO CA
92120-5241
US

V. Phone/Fax

Practice location:
  • Phone: 619-287-7617
  • Fax: 619-287-4536
Mailing address:
  • Phone: 619-287-9100
  • Fax: 619-287-4536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA81531
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: