Basic Information
| Provider Information | |||||||||
| NPI: | 1659994788 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHUQUIMIA | ||||||||
| FirstName: | MEILANI | ||||||||
| MiddleName: | SARAI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1555 ORANGE AVE UNIT 1005 | ||||||||
| Address2: | |||||||||
| City: | REDLANDS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923731459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9517436334 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4445 MAGNOLIA AVE | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925014135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9517883000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2020 | ||||||||
| LastUpdateDate: | 05/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 130429 | CA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 367500000X | 95001316 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.