Provider Demographics
NPI:1831263508
Name:MEYER, THOMAS J (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:MEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2415 CAMPUS DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-1527
Mailing Address - Country:US
Mailing Address - Phone:949-999-3600
Mailing Address - Fax:949-769-8996
Practice Address - Street 1:2415 CAMPUS DR
Practice Address - Street 2:SUITE 110
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1527
Practice Address - Country:US
Practice Address - Phone:949-999-3600
Practice Address - Fax:949-769-8996
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC41786207X00000X
IL036124602207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
A37671Medicare UPIN
IL210961006Medicare PIN
IL210961006Medicare PIN