Healthcare Provider Details

I. General information

NPI: 1740903798
Provider Name (Legal Business Name): CITY OF MERCED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2022
Last Update Date: 09/23/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 E 16TH ST
MERCED CA
95340-5020
US

IV. Provider business mailing address

99 E 16TH ST
MERCED CA
95340-5020
US

V. Phone/Fax

Practice location:
  • Phone: 209-385-6891
  • Fax:
Mailing address:
  • Phone: 209-385-6891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MICKEY DEAN BRUNELLI JR.
Title or Position: BATTALION CHIEF
Credential:
Phone: 209-385-6891