Healthcare Provider Details
I. General information
NPI: 1588960413
Provider Name (Legal Business Name): SAN JOAQUIN EMERGENCY MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/10/2011
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
333 MERCY AVE
MERCED CA
95340-8319
US
IV. Provider business mailing address
4535 DRESSLER RD NW
CANTON OH
44718-2545
US
V. Phone/Fax
- Phone: 844-474-4019
- Fax: 330-493-8677
- Phone: 330-493-4443
- Fax: 330-493-8677
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVEN
P.
MARON
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 925-225-5837