1770872558 NPI number — PERRY ALAN MEIER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770872558 NPI number — PERRY ALAN MEIER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PERRY ALAN MEIER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BEVERLY VASCULAR LABORATORY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770872558
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/09/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8733 BEVERLY BLVD
Provider Second Line Business Mailing Address:
SUITE 306
Provider Business Mailing Address City Name:
WEST HOLLYWOOD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90048-1843
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-854-6450
Provider Business Mailing Address Fax Number:
310-652-5403

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8733 BEVERLY BLVD
Provider Second Line Business Practice Location Address:
SUITE 306
Provider Business Practice Location Address City Name:
WEST HOLLYWOOD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90048-1843
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-854-6450
Provider Business Practice Location Address Fax Number:
310-652-5403
Provider Enumeration Date:
04/01/2011

Additional Information

Authorized Official

Authorized Official Last Name:
MEIER
Authorized Official First Name:
PERRY
Authorized Official Middle Name:
ALAN
Authorized Official Title or Position:
OWNER / DIRECTOR
Authorized Official Telephone Number:
310-854-6450

Provider Taxonomy Codes

  • Taxonomy code: 2471V0105X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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