Individual
ALLISON MERCADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
43520 DIVISION ST, LANCASTER, CA 93535-4089
(661) 266-4783
Mailing address
1020 E PALMDALE BLVD STE 101B, PALMDALE, CA 93550-4756
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
225400000X
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-2633765
MEDI-CAL
CA
Enumeration date
02/28/2019
Last updated
02/28/2019
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