Provider Demographics
NPI:1073504148
Name:MEEHAN, JOHN P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:MEEHAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4860 Y ST
Mailing Address - Street 2:ACC #3800
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2307
Mailing Address - Country:US
Mailing Address - Phone:916-734-5885
Mailing Address - Fax:916-734-7904
Practice Address - Street 1:4860 Y ST
Practice Address - Street 2:ACC #1700
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-2700
Practice Address - Fax:916-703-5074
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2014-05-08
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Provider Licenses
StateLicense IDTaxonomies
CAG761450207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G761450Medicaid
CAG51809Medicare UPIN
CA00G761450Medicaid