Provider Demographics
NPI:1518396753
Name:MEEHAN, TERENCE (MD)
Entity Type:Individual
Prefix:
First Name:TERENCE
Middle Name:
Last Name:MEEHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W ARBOR DR # 0851
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-1911
Mailing Address - Country:US
Mailing Address - Phone:619-471-0249
Mailing Address - Fax:
Practice Address - Street 1:200 W ARBOR DR # 0851
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-1911
Practice Address - Country:US
Practice Address - Phone:415-750-5955
Practice Address - Fax:415-750-8149
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program