MERCED FACULTY ASSOCIATES MEDICAL GROUP INCORPORATED (NPI# 1538300660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538300660 |
| Entity Type | Organization |
| Organization Name | MERCED FACULTY ASSOCIATES MEDICAL GROUP INCORPORATED |
| Other Organization Name | EL PORTAL MEDICAL ONCOLOGY CENTER |
| Practice Address |
3365 G St Merced CA 95340-0994 |
| Mailing Address |
Po Box 3768 Merced CA 95344-3768 |
| Practice Telephone | 2097263410 |
| Practice Fax Number | 2097263371 |
| Mailing Telephone | 2097257149 |
| Mailing Fax Number | 2097260259 |
| Enumeration Date | 2009-03-19 |
| Last Update Date | 2014-07-15 |
| Authorized Official Name | REBECCA SHAW (CEO) |
| Authorized Official Telephone | 2097231920 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QX0200X |
Clinic/Center Specialization: Oncology |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD PIN | ZZZ57772Y | 01 |
| CA | 1538300660 | 05 |
| Other Name | Type Code |
|---|---|
| El Portal Medical Oncology Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215189477 | Merced Faculty Associates Medical Group Incorporated | Family Medicine | 1675 Bellevue Rd, Atwater, CA 95301-2608 | 2008-10-21 |
| 1518119635 | Merced Faculty Associates Medical Group Incorporated | Clinic/Center | 464 E Yosemite Ave, Suite B, Merced, CA 95340-8489 | 2008-10-21 |
| 1518167238 | Merced Faculty Associates Medical Group Incorporated | Family Medicine | 378 W Olive Ave Ste B, Merced, CA 95348-3137 | 2007-07-20 |
| 1619176245 | Merced Faculty Associates Medical Group Incorporated | Family Medicine | 374 W Olive Ave Ste B, Merced, CA 95348-3137 | 2007-07-13 |
| 1982645354 | Merced Faculty Associates Medical Group Incorporated | Family Medicine | 19901 1st St, Suite 4, Hilmar, CA 95324-9071 | 2006-06-09 |
| 1285623256 | Merced Faculty Associates Medical Group Incorporated | Family Medicine | 127 W El Portal Dr, Merced, CA 95348-2853 | 2005-10-20 |
| 1548778954 | Merced Faculty Associates Medical Group Incorporated | Family Medicine | 1675 Shaffer Rd, Atwater, CA 95301-4456 | 2018-01-19 |
| 1841603107 | Merced Faculty Associates Medical Group Incorporated | Family Medicine | 746 Main St, Livingston, CA 95334-1308 | 2014-06-04 |
| 1760650402 | Merced Faculty Associates Medical Group Incorporated | Family Medicine | 378 W Olive Ave, Suite A, Merced, CA 95348-3137 | 2008-02-15 |
| 1699974220 | Merced Faculty Associates Medical Group Incorporated | Family Medicine | 3385 G St Ste A, Merced, CA 95340-0964 | 2007-07-13 |
| Street Address |
3365 G ST |
| City | MERCED |
| State | CA |
| Zip Code | 95340-0994 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700821477 | Merced Mri Medical Group | Clinic/Center | 3365 G St, Suite 100, Merced, CA 95340-0964 | 2006-06-18 |
| 1174552632 | Merced Faculty Associates Medical Group Incorporated | Clinic/Center | 3365 G St, Suite 101, Merced, CA 95340-0994 | 2006-06-30 |
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|---|---|---|---|---|
| 1063045706 | Pharmedquest Pharmacy Services | Pharmacy | 3940 Sandpiper Avenue, Pharmacy 181, Merced, CA 95340 | 2020-02-21 |
| 1548809668 | Michelle Melara | Behavior Technician | 3313 G Street, Suite B, Merced, CA 95340 | 2020-01-06 |
| 1417593070 | Emilio Jose Guzman | Behavior Technician | Autism Learning Partners 3313 G. Street, Suite B, Merced, CA 95340 | 2019-11-19 |
| 1477106383 | Anita Leigh Johnson | Nurse Practitioner | 3349 G Street, Suite C Bldg. K, El Portal Plaza, Merced, CA 95340 | 2019-07-19 |
| 1609439470 | Bobby Shan | Student in an Organized Health Care Education/Training Program | Mercy Medical Center Merced, 315 Mercy Avenue, Ste. 301, Merced, CA 95340 | 2019-04-17 |
| 1508333253 | Golden Valley Health Center | Clinic/Center | 3940 Sandpiper Ave., Merced, CA 95340 | 2018-10-31 |
| 1386136430 | Valley River Orthopedics and Sports Medicine | Orthopaedic Surgery | Valley River Orthopedics & Sports Medicine Inc, 3329 G St Ste A, Merced, CA 95340 | 2018-06-05 |
| 1841702271 | Tou Chang | Pharmacist | 3350 G Street, Merced, CA 95340 | 2017-10-25 |
| 1154842466 | Miller and Skinner Dental Corporation | Dentist | 560 W. 26th St., Merced, CA 95340 | 2017-06-28 |
| 1053859314 | Creative Alternatives, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2025 E. Santa Fe Dr., Merced, CA 95340 | 2017-02-07 |
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| Taxonomy Code | 261QX0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oncology |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment and prescriptive services related to cancerous conditions. Services include chemotherapy infusions and monitoring of implanted chemotherapeutic agents. |
| Notes: [7/1/2003: new] |
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| 1831597061 | Jiyun Jean Kwon | Clinic/Center | 1670 East 120th Street, Mlk Oc Pharmacy, Los Angeles, CA 90059 | 2014-12-22 |
| 1215189709 | Martin J Cline | Clinic/Center | 6901 Panoramic Highway, Stinson Beach, CA 94970-0905 | 2008-10-16 |
| 1477603983 | Epeius Biotechnologies Corporation | Clinic/Center | 475 Huntington Dr, San Marino, CA 91108-2358 | 2007-01-10 |
| 1063486025 | Sequoia Oncology Medical Assoc | Clinic/Center | 857 Garner Ave, Hanford, CA 93230 | 2006-02-15 |
| 1265405328 | Sequoia Oncology Medical Assoc | Clinic/Center | 4945 W Cypress Ave, Ste C, Visalia, CA 93277 | 2006-02-09 |
| 1164077566 | Vaginal and Pelvic Surgeons, Inc | Clinic/Center | 1325 E Church St, Santa Maria, CA 93454-5909 | 2019-08-03 |
| 1558823518 | City of Hope Medical Foundation | Clinic/Center | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2019-04-01 |
| 1356848584 | Colton Health LLC | Clinic/Center | 480 Fourth Ave Ste 409, Chula Vista, CA 91910-4413 | 2018-04-13 |
| 1326566431 | Regents Univ of Calif of Los Angeles | Clinic/Center | 200 Medical Plaza Suite 120, Los Angeles, CA 90095-0001 | 2017-09-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.