Healthcare Provider Details

I. General information

NPI: 1982881645
Provider Name (Legal Business Name): MEERA SOHAIL M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEERA QAYYUM MD

II. Dates (important events)

Enumeration Date: 01/24/2008
Last Update Date: 05/01/2020
Certification Date: 05/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9929 ORCHARD DR
WESTMINSTER CA
92683-5853
US

IV. Provider business mailing address

9929 ORCHARD DR
WESTMINSTER CA
92683-5853
US

V. Phone/Fax

Practice location:
  • Phone: 714-916-0952
  • Fax: 714-594-3286
Mailing address:
  • Phone: 714-916-0952
  • Fax: 714-594-3286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC129795
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberC129795
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: