Healthcare Provider Details

I. General information

NPI: 1750296356
Provider Name (Legal Business Name): ALFREDO S MERCADO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

438 N WHITE RD
SAN JOSE CA
95127-1439
US

IV. Provider business mailing address

944 BAY RD
EAST PALO ALTO CA
94303-1401
US

V. Phone/Fax

Practice location:
  • Phone: 408-254-6828
  • Fax: 408-642-6052
Mailing address:
  • Phone: 650-465-3753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: