Provider Demographics
NPI:1699083519
Name:MYERS, DEBRA J (MD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:J
Last Name:MYERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:46 - E PENINSULA CENTER
Mailing Address - Street 2:#114
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3562
Mailing Address - Country:US
Mailing Address - Phone:310-995-7682
Mailing Address - Fax:310-541-6575
Practice Address - Street 1:23440 HAWTHORNE BLVD.
Practice Address - Street 2:SUITE 150
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4768
Practice Address - Country:US
Practice Address - Phone:310-995-7682
Practice Address - Fax:310-541-6575
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG39266102L00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst