Provider Demographics
NPI:1851595623
Name:MEISEL, LAURA ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ELIZABETH
Last Name:MEISEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:ELIZABETH
Other - Last Name:COONROD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:25751 MCBEAN PKWY
Mailing Address - Street 2:SUITE #210
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-3701
Mailing Address - Country:US
Mailing Address - Phone:661-284-3100
Mailing Address - Fax:
Practice Address - Street 1:25751 MCBEAN PKWY
Practice Address - Street 2:SUITE #210
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-3701
Practice Address - Country:US
Practice Address - Phone:661-284-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71347207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA71347OtherCALIFORNIA MEDICAL LICENSE
CAA71347OtherCALIFORNIA MEDICAL LICENSE
CAOOA713470Medicare ID - Type Unspecified