Healthcare Provider Details

I. General information

NPI: 1508515651
Provider Name (Legal Business Name): EEFA SHEHZAD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 MERCY AVE
MERCED CA
95340-8363
US

IV. Provider business mailing address

315 MERCY AVE
MERCED CA
95340-8363
US

V. Phone/Fax

Practice location:
  • Phone: 209-564-3513
  • Fax:
Mailing address:
  • Phone: 209-564-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA198300
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: