Healthcare Provider Details

I. General information

NPI: 1154626398
Provider Name (Legal Business Name): ANNA MARIE MEDEFIND M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA MARIE BOWSER M.D.

II. Dates (important events)

Enumeration Date: 01/19/2011
Last Update Date: 12/11/2020
Certification Date: 12/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9696 STEPHENS ST
DELHI CA
95315-9550
US

IV. Provider business mailing address

854 ROUND HILL DR
MERCED CA
95348-8422
US

V. Phone/Fax

Practice location:
  • Phone: 209-667-0702
  • Fax:
Mailing address:
  • Phone: 559-289-7506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA122517
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: