Provider Demographics
NPI:1245461383
Name:NICHOLE S. MEISSNER, M.D., INC.
Entity type:Organization
Organization Name:NICHOLE S. MEISSNER, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:MEISSNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-203-1689
Mailing Address - Street 1:1325 N ROSE DR
Mailing Address - Street 2:STE. 202
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-3840
Mailing Address - Country:US
Mailing Address - Phone:714-203-1689
Mailing Address - Fax:714-203-1303
Practice Address - Street 1:1325 N ROSE DR
Practice Address - Street 2:STE 202
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3800
Practice Address - Country:US
Practice Address - Phone:714-203-1689
Practice Address - Fax:714-203-1303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA90718208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty