Provider Demographics
NPI:1336341932
Name:COUNTY OF MERCED
Entity Type:Organization
Organization Name:COUNTY OF MERCED
Other - Org Name:REYES MTU
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATIVE SERVICES DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YADIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-381-1103
Mailing Address - Street 1:260 E 15TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-6216
Mailing Address - Country:US
Mailing Address - Phone:209-381-1200
Mailing Address - Fax:209-381-1215
Practice Address - Street 1:123 S N ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-6818
Practice Address - Country:US
Practice Address - Phone:209-723-1891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy