Healthcare Provider Details

I. General information

NPI: 1811848922
Provider Name (Legal Business Name): MEREK CHRISTOPHER BOONE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5325 N FRESNO ST STE 106
FRESNO CA
93710-6849
US

IV. Provider business mailing address

5275 N CAMPUS DRIVE M/S SG28
FRESNO CA
93740-0001
US

V. Phone/Fax

Practice location:
  • Phone: 877-418-2978
  • Fax: 866-500-2186
Mailing address:
  • Phone: 559-278-2016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: