Provider Demographics
NPI:1902821648
Name:VENZON, MERLIN TUNGOL (MD)
Entity Type:Individual
Prefix:DR
First Name:MERLIN
Middle Name:TUNGOL
Last Name:VENZON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:27303 SLEEPY HOLLOW AVENUE
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-4203
Mailing Address - Country:US
Mailing Address - Phone:510-454-1000
Mailing Address - Fax:510-489-5715
Practice Address - Street 1:27303 SLEEPY HOLLOW AVENUE
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-4203
Practice Address - Country:US
Practice Address - Phone:510-454-1000
Practice Address - Fax:510-489-5715
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2015-05-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA52015208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics