Healthcare Provider Details

I. General information

NPI: 1851335723
Provider Name (Legal Business Name): MARIA M. MERCADO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 05/25/2025
Certification Date: 05/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 3RD AVE
CHULA VISTA CA
91911-1305
US

IV. Provider business mailing address

MS 315010 PO BOX 3947
SEATTLE WA
98124-3947
US

V. Phone/Fax

Practice location:
  • Phone: 619-205-4585
  • Fax:
Mailing address:
  • Phone: 425-467-3655
  • Fax: 425-635-6388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number0430844
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD60287498
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number202331
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number2004022179
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: