Healthcare Provider Details

I. General information

NPI: 1396991253
Provider Name (Legal Business Name): MEGAN M LANGILLE M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2008
Last Update Date: 01/06/2020
Certification Date: 01/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST # 17
TORRANCE CA
90502-2004
US

IV. Provider business mailing address

4650 SUNSET BLVD, MS 82
LOS ANGELES CA
90027
US

V. Phone/Fax

Practice location:
  • Phone: 131-022-2234
  • Fax:
Mailing address:
  • Phone: 181-848-4873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberA110485
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: