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General NPI Number Information
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NPI Number | 1639485543
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Entity Type | Organization
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Legal Business Name | MARILYN G. MYERS, M.D., APC
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Dates
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Enumeration Date | 08/30/2010
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Last Update Date | 10/13/2010
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Provider Practice Location Address
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Address Line | 2220 E FRUIT ST STE 217
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City | SANTA ANA
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State | CA
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Zip | 92701-4459
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Country | US
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Telephone | 714-541-3393
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Fax | 714-541-8830
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Provider Business Mailing Address
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Address Line | 2220 E FRUIT ST STE 217
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City | SANTA ANA
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State | CA
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Zip | 92701-4459
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Country | US
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Telephone | 714-541-3393
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Fax | 714-541-8830
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARILYN G MYERS
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Credential | M.D.
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Telephone | 714-541-3393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | C23521
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License Number State | CA
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