Healthcare Provider Details

I. General information

NPI: 1225035884
Provider Name (Legal Business Name): KAREN ELAINE MERCOLA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6901 PANORAMIC HIGHWAY
STINSON BEACH CA
94970-0297
US

IV. Provider business mailing address

PO BOX 297
STINSON BEACH CA
94970-0297
US

V. Phone/Fax

Practice location:
  • Phone: 415-868-1358
  • Fax: 415-862-5000
Mailing address:
  • Phone: 415-868-1358
  • Fax: 415-862-5000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberG30394
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: