Provider Demographics
NPI:1760578744
Name:MERKES, KEVIN BURTON (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:BURTON
Last Name:MERKES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:NORTH COUNTY INTERNISTS MEDICAL CORPORATION
Mailing Address - Street 2:15525 POMERADO ROAD SUITE A1
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2021
Mailing Address - Country:US
Mailing Address - Phone:858-485-6644
Mailing Address - Fax:858-485-0371
Practice Address - Street 1:15525 POMERADO RD STE A1
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2425
Practice Address - Country:US
Practice Address - Phone:858-485-6444
Practice Address - Fax:858-485-0371
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA77209207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA77209BMedicare ID - Type Unspecified
CAH94586Medicare UPIN