Provider Demographics
NPI:1679675441
Name:MENG, FANHUA (D M D)
Entity Type:Individual
Prefix:DR
First Name:FANHUA
Middle Name:
Last Name:MENG
Suffix:
Gender:F
Credentials:D M D
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:MENG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:832 LOBOS ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-1916
Mailing Address - Country:US
Mailing Address - Phone:530-400-3994
Mailing Address - Fax:
Practice Address - Street 1:832 LOBOS ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-1916
Practice Address - Country:US
Practice Address - Phone:530-400-3994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA527581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice