1174678742 NPI number — DR. MERCEDES ISABEL PATEE M.D.

Table of content: DR. MERCEDES ISABEL PATEE M.D. (NPI 1174678742)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174678742 NPI number — DR. MERCEDES ISABEL PATEE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATEE
Provider First Name:
MERCEDES
Provider Middle Name:
ISABEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174678742
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15629 PROSPECT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
REDDING
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
96001-9504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-633-1441
Provider Business Mailing Address Fax Number:
888-633-1441

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
376 HARTNELL AVE STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96002-1881
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-633-1441
Provider Business Practice Location Address Fax Number:
888-633-1441
Provider Enumeration Date:
01/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  A98141 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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