Healthcare Provider Details

I. General information

NPI: 1497104251
Provider Name (Legal Business Name): ANNA MEKHED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2016
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 HOWARD AVE APT 5
SAN DIEGO CA
92104-1850
US

IV. Provider business mailing address

2815 HOWARD AVE APT 5
SAN DIEGO CA
92104-1850
US

V. Phone/Fax

Practice location:
  • Phone: 619-350-4725
  • Fax: 619-326-3898
Mailing address:
  • Phone: 619-384-4766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95004377
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: