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General NPI Number Information
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NPI Number | 1417779539
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Entity Type | Individual
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Provider Name | PEDRO A MEJIA SUM
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Gender | Male
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 09/13/2025
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Provider Practice Location Address
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Address Line | 160 S 7TH AVE
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City | LA PUENTE
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State | CA
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Zip | 91746-3211
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Country | US
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Telephone | 626-961-8971
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Fax |
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Provider Business Mailing Address
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Address Line | 10 W BAY STATE ST UNIT 393
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City | ALHAMBRA
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State | CA
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Zip | 91802-2816
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 125963
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License Number State | CA
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