Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | C39446 | CA |
N | 207VX0000X | Obstetrician | C39446 | CA |
NPI | 1255372942 |
---|---|
Provider Name | Dr. Saturnina De Leon Mercado |
First Address | Bellflower, CA 90706 |
Second Address | Bellflower, CA 90706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2006 |
Last Update Date | 15/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C394460 | (05) | CA |
B50728 | (02) |