Healthcare Provider Details

I. General information

NPI: 1437277530
Provider Name (Legal Business Name): NANCY LYNNE MAYER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 12/29/2021
Certification Date: 12/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16720 SYCAMORE AVE
PATTERSON CA
95363-9724
US

IV. Provider business mailing address

16720 SYCAMORE AVE
PATTERSON CA
95363-9724
US

V. Phone/Fax

Practice location:
  • Phone: 610-557-2459
  • Fax:
Mailing address:
  • Phone: 209-214-6207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number0101235639
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG88557
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: