Provider Demographics
NPI:1891731832
Name:MEOLI, CHRISTOPHER J (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:MEOLI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35800 BOB HOPE DR
Mailing Address - Street 2:INTERVENTIONAL RADIOLOGY AND IMAGING CENTER, SUITE 150
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1739
Mailing Address - Country:US
Mailing Address - Phone:760-770-1920
Mailing Address - Fax:760-324-0848
Practice Address - Street 1:35800 BOB HOPE DR
Practice Address - Street 2:INTERVENTIONAL RADIOLOGY AND IMAGING CENTER, SUITE 150
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-1739
Practice Address - Country:US
Practice Address - Phone:760-770-1920
Practice Address - Fax:760-324-0848
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO344352085R0202X
CA20A 106542085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
117809OtherMO BLUE
223318OtherHEALTHLINK
OK100016850BMedicaid
KS100230830BMedicaid
MO240912071Medicaid
KS100230830BMedicaid
117809OtherMO BLUE
A13667Medicare UPIN