Provider Demographics
NPI:1699245548
Name:MEENA K MEKA MD INC
Entity type:Organization
Organization Name:MEENA K MEKA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MEENA
Authorized Official - Middle Name:K
Authorized Official - Last Name:MEKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-400-3829
Mailing Address - Street 1:2740 S BRISTOL ST STE 208
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6233
Mailing Address - Country:US
Mailing Address - Phone:714-571-4941
Mailing Address - Fax:
Practice Address - Street 1:1650 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-5824
Practice Address - Country:US
Practice Address - Phone:909-391-4138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AJAY G. MEKA M.D. INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty