Provider Demographics
NPI:1043235476
Name:MEZA, ARTHUR (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:
Last Name:MEZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 MEDICAL CENTER DR UNIT 734
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-6963
Mailing Address - Country:US
Mailing Address - Phone:619-934-5684
Mailing Address - Fax:
Practice Address - Street 1:1301 MEDICAL CENTER DR UNIT 734
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6963
Practice Address - Country:US
Practice Address - Phone:619-934-5684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52845208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA52845Medicare ID - Type Unspecified
CAG13638Medicare UPIN