Provider Demographics
NPI:1215192950
Name:MEEHAN, CONOR PAUL (MB, BCH, BAO, MRCPI)
Entity Type:Individual
Prefix:DR
First Name:CONOR
Middle Name:PAUL
Last Name:MEEHAN
Suffix:
Gender:M
Credentials:MB, BCH, BAO, MRCPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10945 LE CONTE AVE, PETER V UEBERROTH BUILDING
Mailing Address - Street 2:STE 3371
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-7206
Mailing Address - Country:US
Mailing Address - Phone:917-318-3407
Mailing Address - Fax:
Practice Address - Street 1:10945 LE CONTE AVE, PETER V UEBERROTH BUILDING
Practice Address - Street 2:STE 3371
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-7206
Practice Address - Country:US
Practice Address - Phone:917-318-3407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP652232085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging