Provider Demographics
NPI:1295950293
Name:WILLIAM R. MEEKER, M.D., A MEDICAL CORPORATION
Entity type:Organization
Organization Name:WILLIAM R. MEEKER, M.D., A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MEEKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-573-6803
Mailing Address - Street 1:4153 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2047
Mailing Address - Country:US
Mailing Address - Phone:619-573-6803
Mailing Address - Fax:619-298-7267
Practice Address - Street 1:4153 1ST AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2047
Practice Address - Country:US
Practice Address - Phone:619-683-7671
Practice Address - Fax:877-471-6899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG87425261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)