Provider Demographics
NPI:1164950606
Name:MEZA, CARLOS ESTUARDO (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:ESTUARDO
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 1:11815 POUNDS AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-4037
Mailing Address - Country:US
Mailing Address - Phone:562-858-1562
Mailing Address - Fax:
Practice Address - Street 1:PIH HEALTH PHYSICIANS PSYCHIATRY
Practice Address - Street 2:12291 WASHINGTON BLVD. #300
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606
Practice Address - Country:US
Practice Address - Phone:562-697-2840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-29
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1630282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry