Healthcare Provider Details

I. General information

NPI: 1801712427
Provider Name (Legal Business Name): ADNAN MEESA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 4TH ST
SAN RAFAEL CA
94901-2855
US

IV. Provider business mailing address

1407 4TH ST
SAN RAFAEL CA
94901-2855
US

V. Phone/Fax

Practice location:
  • Phone: 978-746-1401
  • Fax:
Mailing address:
  • Phone: 978-746-1401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number97954
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: