Provider Demographics
NPI:1265877336
Name:REEVES, MEGAN DARAH (MD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:DARAH
Last Name:REEVES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2350 W EL CAMINO REAL FL 2
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-6203
Mailing Address - Country:US
Mailing Address - Phone:415-878-7200
Mailing Address - Fax:415-369-1274
Practice Address - Street 1:101 ROWLAND WAY STE 220
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-5056
Practice Address - Country:US
Practice Address - Phone:415-878-7200
Practice Address - Fax:415-369-1274
Is Sole Proprietor?:No
Enumeration Date:2013-05-02
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA135475208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA135475OtherSTATE MEDICAL LICENSE
CAFR6362242OtherFEDERAL DEA LICENSE