Provider Demographics
NPI:1306959069
Name:MERCHANT, E B (MD)
Entity type:Individual
Prefix:
First Name:E
Middle Name:B
Last Name:MERCHANT
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:50 ALESSANDRO PLACE
Mailing Address - Street 2:430
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3170
Mailing Address - Country:US
Mailing Address - Phone:626-795-2226
Mailing Address - Fax:626-795-4770
Practice Address - Street 1:50 ALESSANDRO PLACE
Practice Address - Street 2:430
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3170
Practice Address - Country:US
Practice Address - Phone:626-795-2226
Practice Address - Fax:626-795-4770
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2008-01-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG33726207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G33726Medicare PIN