Provider Demographics
NPI:1538485099
Name:TAYNET T FEBLES MD INC
Entity type:Organization
Organization Name:TAYNET T FEBLES MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAYNET
Authorized Official - Middle Name:T
Authorized Official - Last Name:FEBLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-233-0023
Mailing Address - Street 1:731 E YOSEMITE AVE
Mailing Address - Street 2:SUITE B, PMB #209
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-8039
Mailing Address - Country:US
Mailing Address - Phone:209-233-0023
Mailing Address - Fax:888-901-5030
Practice Address - Street 1:916 I ST
Practice Address - Street 2:
Practice Address - City:LOS BANOS
Practice Address - State:CA
Practice Address - Zip Code:93635-4313
Practice Address - Country:US
Practice Address - Phone:209-233-0023
Practice Address - Fax:888-901-5030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA109536207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty