Provider Demographics
NPI:1700124773
Name:SHUKLA, MEERA MISRA (MD)
Entity Type:Individual
Prefix:DR
First Name:MEERA
Middle Name:MISRA
Last Name:SHUKLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:361 HOSPITAL RD
Mailing Address - Street 2:STE 322
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3522
Mailing Address - Country:US
Mailing Address - Phone:949-574-0777
Mailing Address - Fax:949-650-3505
Practice Address - Street 1:361 HOSPITAL RD
Practice Address - Street 2:STE 322
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3522
Practice Address - Country:US
Practice Address - Phone:949-574-0777
Practice Address - Fax:949-650-3505
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-24
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA120624207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine