Provider Demographics
NPI:1851598536
Name:FAMILY PRACTICE RESIDENCY
Entity Type:Organization
Organization Name:FAMILY PRACTICE RESIDENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAUJO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-385-7175
Mailing Address - Street 1:315 E 13TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-6211
Mailing Address - Country:US
Mailing Address - Phone:209-385-7175
Mailing Address - Fax:209-385-7017
Practice Address - Street 1:315 E 13TH ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-6211
Practice Address - Country:US
Practice Address - Phone:209-385-7175
Practice Address - Fax:209-385-7017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty