Provider Demographics
NPI:1639740582
Name:BUCHANAN, MEGHAN PATRICIA
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:PATRICIA
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1727 CARRIE HILLS LN
Mailing Address - Street 2:
Mailing Address - City:LA HABRA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:90631-8277
Mailing Address - Country:US
Mailing Address - Phone:562-365-4989
Mailing Address - Fax:
Practice Address - Street 1:3002 DOW AVE STE 314
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-7234
Practice Address - Country:US
Practice Address - Phone:562-365-4989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31406235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist