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Individual

ALEX J. MERCANDETTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4060 FOURTH AVE, SUITE 335, SAN DIEGO, CA 92103-2116
(619) 291-9285
(619) 291-9289
Mailing address
4060 FOURTH AVE, SUITE 335, SAN DIEGO, CA 92103-2116
(619) 291-9285
(619) 291-9289

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G41199
CA
207RP1001X
Pulmonary Disease Physician
G41199
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0084400
CA
Enumeration date
06/27/2006
Last updated
12/27/2007
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