Basic Information
Provider Information
NPI: 1851625867
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MEYERS
FirstName: JOHN
MiddleName: JAMES
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2952 BURTON CIR
Address2:  
City: CAMBRIA
State: CA
PostalCode: 934283904
CountryCode: US
TelephoneNumber: 8059275566
FaxNumber:  
Practice Location
Address1: 500 W FOSTER RD
Address2:  
City: SANTA MARIA
State: CA
PostalCode: 934553620
CountryCode: US
TelephoneNumber: 8059346380
FaxNumber: 8059346519
Other Information
ProviderEnumerationDate: 09/23/2009
LastUpdateDate: 06/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XG67051CAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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