MEDICARE: DR. MEIR BEN-SHOSHAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	AFE24635	CA

General Provider Information

NPI Number	:	1144546037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEIR BEN-SHOSHAN M.D.

Provider Business Mailing Address
First Line	:	17099 EDGEWATER LN
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-4207
Country	:	US
Telephone Number	:	714-846-0412
Fax Number	:

Provider Business Practice Location Address
First Line	:	17099 EDGEWATER LN
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-4207
Country	:	US
Telephone Number	:	714-846-0412
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2010
Last Update Date	:	04/16/2010

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