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Organization
MERCED FACULTY ASSOCIATES MEDICAL GROUP INCORPORATED
Active
Organization
MERCED FACULTY ASSOCIATES MEDICAL GROUP INCORPORATED
Active
Other names
MFA Medical Group @ El Portal
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA SHAW (CEO)
(209) 723-1920
Entity
Organization
Contact information
Practice address
3385 G ST STE A, MERCED, CA 95340-0964
(209) 725-3122
(209) 725-3128
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
—
GR0041487
—
CA
01
—
ZZZ69713Z
BLUE SHIELD GROUP
CA
Enumeration date
07/13/2007
Last updated
07/15/2014
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