Provider Demographics
NPI:1962944389
Name:MERCADO, ARMAN
Entity type:Individual
Prefix:
First Name:ARMAN
Middle Name:
Last Name:MERCADO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34178 DUKE LN
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-2524
Mailing Address - Country:US
Mailing Address - Phone:510-303-7822
Mailing Address - Fax:510-745-8479
Practice Address - Street 1:34178 DUKE LN
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94555-2524
Practice Address - Country:US
Practice Address - Phone:510-303-7822
Practice Address - Fax:510-745-8479
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA083849343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)