Provider Demographics
NPI:1669483590
Name:MEJIA, METHUSA JAVINAR (MD)
Entity Type:Individual
Prefix:DR
First Name:METHUSA
Middle Name:JAVINAR
Last Name:MEJIA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:35800 BOB HOPE DR STE 220
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1739
Mailing Address - Country:US
Mailing Address - Phone:760-464-0561
Mailing Address - Fax:760-464-0562
Practice Address - Street 1:73950 ALESSANDRO DR STE 5
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-3637
Practice Address - Country:US
Practice Address - Phone:760-341-9906
Practice Address - Fax:760-341-9916
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2013-05-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA740580170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics