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General NPI Number Information
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NPI Number | 1710839568
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Entity Type | Organization
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Legal Business Name | MERCYGO LLC
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Dates
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Enumeration Date | 02/13/2026
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 1151 HARBOR BAY PKWY STE 207G
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City | ALAMEDA
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State | CA
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Zip | 94502-6540
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Country | US
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Telephone | 415-589-8695
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Fax |
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Provider Business Mailing Address
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Address Line | 1151 HARBOR BAY PKWY STE 207G
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City | ALAMEDA
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State | CA
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Zip | 94502-6540
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | YABETSE TESSEMA
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Credential | MD, MSC
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Telephone | 415-589-8695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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