Organization
MERCED PULMONARY MEDICAL ASSOC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICK MADDOCKS (PRESIDENT)
(209) 526-8038
Entity
Organization
Contact information
Practice address
780 W OLIVE AVE., STE 103, MERCED, CA 95348
(209) 526-8038
(209) 526-6841
Mailing address
780 W OLIVE AVE., STE 103, MERCED, CA 95348
(209) 723-0783
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
GR0045160
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C41002
MEDICARE ID
CA
Enumeration date
06/08/2006
Last updated
03/06/2008
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