Healthcare Provider Details

I. General information

NPI: 1467575126
Provider Name (Legal Business Name): DAWN M MEYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DAWN E MATHERNE APRN,BC,FNP

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 01/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ARBOR DR MON 3RD FLOOR SUITE 3
SAN DIEGO CA
92103-9001
US

IV. Provider business mailing address

PO BOX 232410
SAN DIEGO CA
92193-2410
US

V. Phone/Fax

Practice location:
  • Phone: 619-543-2871
  • Fax: 619-543-7771
Mailing address:
  • Phone: 800-926-8273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number15769
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: