Provider Demographics
NPI:1689977480
Name:O'FARRELL, MEGAN JOYCE (LAC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:JOYCE
Last Name:O'FARRELL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2900 BRISTOL ST STE J106
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-7919
Mailing Address - Country:US
Mailing Address - Phone:818-395-3451
Mailing Address - Fax:
Practice Address - Street 1:2900 BRISTOL ST STE J106
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-7919
Practice Address - Country:US
Practice Address - Phone:310-803-5459
Practice Address - Fax:866-706-9964
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 13969171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist