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General NPI Number Information
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NPI Number | 1700821477
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Entity Type | Organization
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Legal Business Name | MERCED MRI MEDICAL GROUP
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 3365 G ST SUITE 100
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City | MERCED
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State | CA
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Zip | 95340-0964
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Country | US
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Telephone | 209-384-2121
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Fax | 209-384-4269
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Provider Business Mailing Address
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Address Line | PO BOX 1350
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City | SUISUN CITY
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State | CA
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Zip | 94585-4350
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Country | US
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Telephone | 209-384-4250
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Fax |
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Authorized Official
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Title or Position | MANAGING EMPLOYEE
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Name | KAREN HANSEN
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Credential |
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Telephone | 209-384-4250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State | CA
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