Provider Demographics
NPI:1346313335
Name:MEYER, ANN R (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:R
Last Name:MEYER
Suffix:
Gender:F
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:PO BOX 641757
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064
Mailing Address - Country:US
Mailing Address - Phone:310-473-5151
Mailing Address - Fax:310-473-6787
Practice Address - Street 1:11600 WILSHIRE BLVD
Practice Address - Street 2:#412
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025
Practice Address - Country:US
Practice Address - Phone:310-473-5151
Practice Address - Fax:310-473-6787
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG70544208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G705440Medicaid
F67970Medicare UPIN
CA00G705440Medicaid