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Organization

MERCED FACULTY ASSOCIATES MEDICAL GROUP INCORPORATED

Active
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Organization

MERCED FACULTY ASSOCIATES MEDICAL GROUP INCORPORATED

Active
Other names
MFA Parkside
Organization subpart
No

Provider details

NPI number
Authorized official
REBECCA SHAW (CEO)
(209) 723-1920
Entity
Organization

Contact information

Practice address
535 W 25TH ST, MERCED, CA 95340-2801
(209) 722-9066
(209) 383-1522
Mailing address
PO BOX 3768, MERCED, CA 95344-3768
(209) 725-7149
(209) 726-0259

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS1342
RAILROAD MEDICARE
GA
05
—
GR0041482
MEDI-CAL GROUP NUMBER
CA
01
—
ZZZ61443Z
BLUE SHIELD GROUP NUMBER
CA
Enumeration date
07/13/2007
Last updated
07/15/2014
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