Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | A102455 | CA |
NPI | 1003042987 |
---|---|
Provider Name | Dr. Yasser Salim Ratl Mrad |
First Address | Merced, CA 95341-6805 |
Second Address | Merced, CA 95341-6805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2009 |
Last Update Date | 08/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A102455 | MEDICAL LICENSE (01) | CA |
FR1385978 | DEA (01) | CA |