Provider Demographics
NPI:1467404038
Name:MYERS, RHONDA JAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:JAN
Last Name:MYERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4902 IRVINE CENTER DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-3305
Mailing Address - Country:US
Mailing Address - Phone:949-552-3121
Mailing Address - Fax:949-552-3723
Practice Address - Street 1:4902 IRVINE CENTER DR
Practice Address - Street 2:SUITE 108
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-3305
Practice Address - Country:US
Practice Address - Phone:949-552-3121
Practice Address - Fax:949-552-3723
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG55983207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA40554Medicare UPIN