Organization
MERCY MEDICAL GROUP
Active
Parent organization
MEDVANTX, INC.
Other names
Mercy Medical Group - Cameron Park, a Service of CHW
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (SR. DIRECTOR OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
3427 ROBIN LN, 100, CAMERON PARK, CA 95682-7254
(530) 676-7337
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
G64540
CA
Other
Enumeration date
08/20/2010
Last updated
10/23/2012
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