Provider Demographics
NPI:1952314205
Name:PURAY, MERLA E (MD)
Entity Type:Individual
Prefix:
First Name:MERLA
Middle Name:E
Last Name:PURAY
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 1:3175 COLLINS DR
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-3133
Mailing Address - Country:US
Mailing Address - Phone:209-722-5100
Mailing Address - Fax:209-722-5200
Practice Address - Street 1:3175 COLLINS DR
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-3133
Practice Address - Country:US
Practice Address - Phone:209-722-5100
Practice Address - Fax:209-722-5200
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98668207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A986680Medicaid
CA6231460001Medicare NSC
CAI11546Medicare UPIN
CA00A986680Medicaid