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General NPI Number Information
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NPI Number | 1144515792
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Entity Type | Individual
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Provider Name | FAITH CHERYLE ABALOS MERINO MD
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Gender | Female
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Dates
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Enumeration Date | 06/11/2011
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 1301 PINOLE VALLEY RD
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City | PINOLE
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State | CA
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Zip | 94564-1384
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Country | US
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Telephone | 510-243-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 15 BONNY DOONE
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City | HERCULES
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State | CA
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Zip | 94547-3947
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Country | US
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Telephone | 714-875-9367
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME110135
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C138791
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License Number State | CA
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