Healthcare Provider Details

I. General information

NPI: 1851595623
Provider Name (Legal Business Name): LAURA ELIZABETH MEISEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA ELIZABETH COONROD MD

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 01/10/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25751 MCBEAN PKWY SUITE #210
VALENCIA CA
91355-3701
US

IV. Provider business mailing address

25751 MCBEAN PKWY SUITE #210
VALENCIA CA
91355-3701
US

V. Phone/Fax

Practice location:
  • Phone: 661-284-3100
  • Fax:
Mailing address:
  • Phone: 661-284-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA71347
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: