Healthcare Provider Details

I. General information

NPI: 1780656512
Provider Name (Legal Business Name): RENATO DAUIGOY YUZON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 E YOSEMITE AVE
MERCED CA
95340-9167
US

IV. Provider business mailing address

3534 SANTIAGO AVE
MERCED CA
95348-9500
US

V. Phone/Fax

Practice location:
  • Phone: 209-381-0105
  • Fax: 209-381-0101
Mailing address:
  • Phone: 209-384-4400
  • Fax: 209-384-4126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA54499
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA54499
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: