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NPI Code Detail

MEDICARE: MICK SCOTT MEISELMAN MD

MEDICARE: MICK SCOTT MEISELMAN MD
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
1207RG0100XGastroenterology PhysicianG42562CA

General Provider Information

NPI Number : 1801897012
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICK SCOTT MEISELMAN MD
Provider Business Mailing Address
First Line : 1551 BISHOP ST STE 230
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-4661
Country : US
Telephone Number : 805-434-5530
Fax Number : 805-556-3090
Provider Business Practice Location Address
First Line : 1304 ELLA ST STE A
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-4165
Country : US
Telephone Number : 805-549-9555
Fax Number : 805-549-0444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 11/03/2023

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