Provider Demographics
NPI:1679656193
Name:ASUNCION, MERLYN M (MD)
Entity Type:Individual
Prefix:DR
First Name:MERLYN
Middle Name:M
Last Name:ASUNCION
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14555 HAMLIN ST
Mailing Address - Street 2:STE 108
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-1612
Mailing Address - Country:US
Mailing Address - Phone:818-781-2796
Mailing Address - Fax:818-781-2797
Practice Address - Street 1:14555 HAMLIN ST
Practice Address - Street 2:STE 108
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-1612
Practice Address - Country:US
Practice Address - Phone:818-781-2796
Practice Address - Fax:818-781-2797
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-21
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49850207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A498501/6447926Medicaid
CA00A498501/6447926Medicaid
CAF36699Medicare UPIN