# MERCED FACULTY ASSOCIATES MEDICAL GROUP INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285623256
- **Authorized official:** MRS. REBECCA L SHAW (CEO)
- **Authorized official phone:** (209) 723-1920

## Contact information

- **Practice address:** 127 W EL PORTAL DR, MERCED, CA 95348-2853
- **Practice address phone:** (209) 723-3704
- **Practice address fax:** (209) 723-0272
- **Mailing address:** PO BOX 3768, MERCED, CA 95344-3768
- **Mailing address phone:** (209) 725-7149
- **Mailing address fax:** (209) 726-0134

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/20/2005
- **Last updated:** 01/06/2020