Healthcare Provider Details

I. General information

NPI: 1538252457
Provider Name (Legal Business Name): MERCED HEART ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 MERCY AVE
MERCED CA
95340-8319
US

IV. Provider business mailing address

310 MERCY AVE
MERCED CA
95340-8319
US

V. Phone/Fax

Practice location:
  • Phone: 209-383-3456
  • Fax: 209-722-6084
Mailing address:
  • Phone: 209-383-3456
  • Fax: 209-722-6084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: HEATHER BARRON
Title or Position: PRACTICE MANAGER
Credential:
Phone: 209-383-3456