Healthcare Provider Details

I. General information

NPI: 1700821477
Provider Name (Legal Business Name): MERCED MRI MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3365 G ST SUITE 100
MERCED CA
95340-0964
US

IV. Provider business mailing address

PO BOX 1350
SUISUN CITY CA
94585-4350
US

V. Phone/Fax

Practice location:
  • Phone: 209-384-2121
  • Fax: 209-384-4269
Mailing address:
  • Phone: 209-384-4250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KAREN HANSEN
Title or Position: MANAGING EMPLOYEE
Credential:
Phone: 209-384-4250