MEDICARE: WENDY MEJIA

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	171M00000X	Case Manager/Care Coordinator		CA

General Provider Information

NPI Number	:	1801750161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY MEJIA

Provider Business Mailing Address
First Line	:	2202 W MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90008-2723
Country	:	US
Telephone Number	:	323-508-0155
Fax Number	:

Provider Business Practice Location Address
First Line	:	2202 W MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90008-2723
Country	:	US
Telephone Number	:	323-508-0155
Fax Number	:

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

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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