Provider Demographics
NPI:1538718218
Name:VERONA MEDICAL GROUP INC.
Entity type:Organization
Organization Name:VERONA MEDICAL GROUP INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VERONA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MALABED-VERONA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-261-5296
Mailing Address - Street 1:2121 LEGENDS CT
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-0740
Mailing Address - Country:US
Mailing Address - Phone:209-261-5296
Mailing Address - Fax:209-384-4126
Practice Address - Street 1:900 W OLIVE AVE STE B
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-2401
Practice Address - Country:US
Practice Address - Phone:209-384-4400
Practice Address - Fax:209-384-4126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-05
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty