Healthcare Provider Details

I. General information

NPI: 1336162148
Provider Name (Legal Business Name): BENJAMIN HARRIS MEISEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BEN HARRIS MEISEL MD

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27506 BERKSHIRE HILLS PL
VALENCIA CA
91354-1829
US

IV. Provider business mailing address

27506 BERKSHIRE HILLS PL
VALENCIA CA
91354-1829
US

V. Phone/Fax

Practice location:
  • Phone: 661-284-5969
  • Fax: 661-284-5969
Mailing address:
  • Phone: 661-284-5969
  • Fax: 661-284-5969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA78935
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: