Provider Demographics
NPI:1245871722
Name:MEI, TERESA (OD)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:
Last Name:MEI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 ANTON BLVD UNIT 448
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-7048
Mailing Address - Country:US
Mailing Address - Phone:312-520-7288
Mailing Address - Fax:
Practice Address - Street 1:2240 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-5311
Practice Address - Country:US
Practice Address - Phone:310-554-1543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34400TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist