Basic Information
| Provider Information | |||||||||
| NPI: | 1124494034 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MERCY FAMILY HEALTH CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2480 SONOMA ST | ||||||||
| Address2: | |||||||||
| City: | REDDING | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960013027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5302257800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2480 SONOMA ST | ||||||||
| Address2: | |||||||||
| City: | REDDING | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960013027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5302257800 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2015 | ||||||||
| LastUpdateDate: | 09/14/2015 | ||||||||
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| AuthorizedOfficialLastName: | XU | ||||||||
| AuthorizedOfficialFirstName: | BING | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 5302257800 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | UC DAVIS | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | N | Hospitals | General Acute Care Hospital | 261Q00000X | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.