Provider Demographics
NPI:1982881645
Name:SOHAIL, MEERA (MD)
Entity Type:Individual
Prefix:
First Name:MEERA
Middle Name:
Last Name:SOHAIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MEERA
Other - Middle Name:
Other - Last Name:QAYYUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9929 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5853
Mailing Address - Country:US
Mailing Address - Phone:714-916-0952
Mailing Address - Fax:714-594-3286
Practice Address - Street 1:9929 ORCHARD DR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5853
Practice Address - Country:US
Practice Address - Phone:714-916-0952
Practice Address - Fax:714-594-3286
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC129795207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB8100Medicare PIN
NY02974683Medicaid