Individual
MEGHAN MARIE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6195 LUSK BLVD STE 250, SAN DIEGO, CA 92121-3715
(858) 859-1188
Mailing address
6195 LUSK BLVD STE 250, SAN DIEGO, CA 92121-3715
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
54064
CA
363AM0700X
Medical Physician Assistant
Primary
54064
CA
Other
Enumeration date
12/13/2016
Last updated
12/06/2022
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