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General NPI Number Information
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NPI Number | 1275210866
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Entity Type | Individual
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Provider Name | MENA MECHAEL
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Gender | Male
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Dates
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Enumeration Date | 07/05/2023
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 4600 PANAMA LN UNIT 102B
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City | BAKERSFIELD
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State | CA
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Zip | 93313-3511
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Country | US
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Telephone | 661-707-6665
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Fax |
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Provider Business Mailing Address
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Address Line | 4101 BRITTANY ST APT 203
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City | BAKERSFIELD
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State | CA
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Zip | 93312-2368
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Country | US
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Telephone | 661-308-7941
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 87999
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License Number State | CA
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