Basic Information
| Provider Information | |||||||||
| NPI: | 1003860248 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEINTS | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | HENRY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1809 | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928560809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145601580 | ||||||||
| FaxNumber: | 7145601585 | ||||||||
| Practice Location | |||||||||
| Address1: | 1783 EL CAMINO REAL | ||||||||
| Address2: | |||||||||
| City: | BURLINGAME | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940103205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6506965400 | ||||||||
| FaxNumber: | 6506965208 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2006 | ||||||||
| LastUpdateDate: | 03/05/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A62427 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 00A624270 | 05 | CA | MEDICAID |