Basic Information
| Provider Information | |||||||||
| NPI: | 1295867919 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEIJER | ||||||||
| FirstName: | ROSALIE | ||||||||
| MiddleName: | LORIAN | ||||||||
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| Credential: | PA-C, MMS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 176 KINGSTON AVE APT C | ||||||||
| Address2: | |||||||||
| City: | GOLETA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931172322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056920725 | ||||||||
| FaxNumber: | 8055697890 | ||||||||
| Practice Location | |||||||||
| Address1: | 320 W PUEBLO ST | ||||||||
| Address2: | SANTA BARBARA COTTAGE HOSPITAL - TRAUMA SERVICES | ||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931054311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055697451 | ||||||||
| FaxNumber: | 8055697890 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA-16300 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 9101798 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.