Provider Demographics
NPI:1770961971
Name:NOVO, MEGAN ELISABETH (MD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELISABETH
Last Name:NOVO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ELISABETH
Other - Last Name:REINDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3923 WARING RD STE A
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4499
Mailing Address - Country:US
Mailing Address - Phone:760-724-8782
Mailing Address - Fax:760-842-7801
Practice Address - Street 1:3923 WARING RD STE A
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4499
Practice Address - Country:US
Practice Address - Phone:760-724-8782
Practice Address - Fax:760-842-7801
Is Sole Proprietor?:No
Enumeration Date:2015-05-08
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA147981207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology