Healthcare Provider Details

I. General information

NPI: 1174503395
Provider Name (Legal Business Name): CAROLYN RHENE MERKOURIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLYN RHENE MERKOURIS MD

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 COTTONWOOD ST FL 3
WOODLAND CA
95695-5131
US

IV. Provider business mailing address

1321 COTTONWOOD ST FL 3
WOODLAND CA
95695-5131
US

V. Phone/Fax

Practice location:
  • Phone: 530-668-2600
  • Fax: 530-661-2410
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number4440
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG71953
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberG71953
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: