MEDICARE: DR. CHRISTOPHER CHARLES MEYER PH.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	103TC0700X	Clinical Psychologist	19485	CA

General Provider Information

NPI Number	:	1699807768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER CHARLES MEYER PH.D.

Provider Business Mailing Address
First Line	:	5919 W 3RD ST
Second Line	:	SUITE 1-E
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-2833
Country	:	US
Telephone Number	:	323-930-9662
Fax Number	:

Provider Business Practice Location Address
First Line	:	5919 W 3RD ST
Second Line	:	SUITE 1-E
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-2833
Country	:	US
Telephone Number	:	323-930-9662
Fax Number	:

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

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	08/16/2012

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