Basic Information
| Provider Information | |||||||||
| NPI: | 1659444552 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JAMES L MERSON M.D., INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2757 | ||||||||
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| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928590757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7149732650 | ||||||||
| FaxNumber: | 7149732655 | ||||||||
| Practice Location | |||||||||
| Address1: | 39700 BOB HOPE DR STE 111 | ||||||||
| Address2: | |||||||||
| City: | RANCHO MIRAGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922703267 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603403937 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2006 | ||||||||
| LastUpdateDate: | 10/04/2007 | ||||||||
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| AuthorizedOfficialLastName: | MERSON | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7149732650 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | G21375 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.