Provider Demographics
NPI:1396936068
Name:FOSTER, MEGAN ASHLEY (MD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:ASHLEY
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72782 BEL AIR RD
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-6003
Mailing Address - Country:US
Mailing Address - Phone:760-779-0906
Mailing Address - Fax:
Practice Address - Street 1:72782 BEL AIR RD
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-6003
Practice Address - Country:US
Practice Address - Phone:760-779-0906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA669972085R0202X
NM2002-03742085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A669970OtherBS
CA1396936068Medicaid
CADJ229XMedicare PIN