Provider Demographics
NPI:1477699338
Name:MESO SOLUTIONS, MD A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:MESO SOLUTIONS, MD A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-908-9135
Mailing Address - Street 1:14545 FRIAR STREET
Mailing Address - Street 2:#104
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411
Mailing Address - Country:US
Mailing Address - Phone:818-908-9135
Mailing Address - Fax:818-908-5983
Practice Address - Street 1:14545 FRIAR ST
Practice Address - Street 2:#104
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-2357
Practice Address - Country:US
Practice Address - Phone:818-908-9135
Practice Address - Fax:818-908-5983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33673302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW17095Medicare ID - Type Unspecified