Provider Demographics
NPI:1699087072
Name:MERCED COUNTY PHYSICIANS
Entity type:Organization
Organization Name:MERCED COUNTY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:GENARGUE
Authorized Official - Last Name:ENAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-384-9108
Mailing Address - Street 1:410 E YOSEMITE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-8220
Mailing Address - Country:US
Mailing Address - Phone:209-384-9108
Mailing Address - Fax:209-384-0580
Practice Address - Street 1:410 E YOSEMITE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-8220
Practice Address - Country:US
Practice Address - Phone:209-384-9108
Practice Address - Fax:209-384-0580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49631261QP2300X
CAC50505261QP2300X
CAA54997261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care