Healthcare Provider Details

I. General information

NPI: 1366864076
Provider Name (Legal Business Name): MEERA CHAPPIDI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2014
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVE. BLDG. 5, 5TH FLOOR, SUITE 5A
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

PO BOX 743749
LOS ANGELES CA
90074-3749
US

V. Phone/Fax

Practice location:
  • Phone: 628-206-8265
  • Fax: 628-206-4305
Mailing address:
  • Phone: 415-514-3000
  • Fax: 415-502-8175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberA156945
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: