Healthcare Provider Details

I. General information

NPI: 1013077841
Provider Name (Legal Business Name): MICHAEL J MENG DC RMSK RN FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3633 CAMINO DEL RIO S STE 300
SAN DIEGO CA
92108-4014
US

IV. Provider business mailing address

3633 CAMINO DEL RIO S STE 300
SAN DIEGO CA
92108-4014
US

V. Phone/Fax

Practice location:
  • Phone: 619-287-9730
  • Fax:
Mailing address:
  • Phone: 619-287-9730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number29727
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNPF95028041
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: