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General NPI Number Information
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NPI Number | 1861490914
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Entity Type | Organization
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Legal Business Name | KELLEE D. MEYER, O.D., INC.
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 2848 PARK AVE SUITE A
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City | MERCED
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State | CA
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Zip | 95348-3375
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Country | US
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Telephone | 209-383-1408
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Fax | 209-383-3836
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Provider Business Mailing Address
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Address Line | 2848 PARK AVE SUITE A
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City | MERCED
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State | CA
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Zip | 95348-3375
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Country | US
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Telephone | 209-383-1408
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Fax | 209-383-3836
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KELLEE D. MEYER
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Credential | O.D.
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Telephone | 209-383-1408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 992
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License Number State | CA
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