Basic Information
| Provider Information | |||||||||
| NPI: | 1396015889 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MERCHANT | ||||||||
| FirstName: | RAYMOND | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26232 GLEN CANYON DR | ||||||||
| Address2: | |||||||||
| City: | LAGUNA HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926536326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9498311441 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 30300 CAMINO CAPISTRANO | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN CAPISTRANO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926751304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9492402030 | ||||||||
| FaxNumber: | 9494297627 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/30/2011 | ||||||||
| LastUpdateDate: | 01/30/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | AFE18766 | CA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology |
No ID Information.