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General NPI Number Information
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NPI Number | 1245461383
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Entity Type | Organization
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Legal Business Name | NICHOLE S. MEISSNER, M.D., INC.
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 08/06/2009
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Provider Practice Location Address
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Address Line | 1325 N ROSE DR STE 202
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City | PLACENTIA
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State | CA
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Zip | 92870-3800
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Country | US
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Telephone | 714-203-1689
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Fax | 714-203-1303
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Provider Business Mailing Address
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Address Line | 1325 N ROSE DR STE. 202
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City | PLACENTIA
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State | CA
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Zip | 92870-3840
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Country | US
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Telephone | 714-203-1689
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Fax | 714-203-1303
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICHOLE SUZANNE MEISSNER
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Credential | M.D.
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Telephone | 714-203-1689
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A90718
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License Number State | CA
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