Provider Demographics
NPI:1578679304
Name:NAPONIC, MEARL A (MD)
Entity type:Individual
Prefix:DR
First Name:MEARL
Middle Name:A
Last Name:NAPONIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8851 CENTER DR
Mailing Address - Street 2:#500
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942
Mailing Address - Country:US
Mailing Address - Phone:619-461-2660
Mailing Address - Fax:619-461-5760
Practice Address - Street 1:8851 CENTER DR
Practice Address - Street 2:#500
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3017
Practice Address - Country:US
Practice Address - Phone:619-461-2660
Practice Address - Fax:619-461-5760
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG-13970174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1069524OtherBNDD
CA00G139700OtherMEDI-CAL
CA1069524OtherBNDD
CAWG13970AMedicare PIN