Provider Demographics
NPI:1477964831
Name:MEAGAN M. LITTLEPAGE, M.D., INC.
Entity Type:Organization
Organization Name:MEAGAN M. LITTLEPAGE, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:MEAGAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LITTLEPAGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-705-0114
Mailing Address - Street 1:1484 POLLARD RD
Mailing Address - Street 2:SUITE #423
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1031
Mailing Address - Country:US
Mailing Address - Phone:408-355-3622
Mailing Address - Fax:
Practice Address - Street 1:700 W PARR AVE
Practice Address - Street 2:SUITE A-1
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1442
Practice Address - Country:US
Practice Address - Phone:408-681-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108647208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty