| Alex J. Mercandetti, M.d., Inc. A Professional Corporation | |
|
4060 Fourth Ave Suite 335 San Diego CA 92103-2116 | |
| (619) 291-9285 | |
| (619) 291-9289 |
| Full Name | Alex J. Mercandetti, M.d., Inc. A Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 4060 Fourth Ave, San Diego, California |
| Authorized Official Name and Position | Alex J. Mercandetti (PRESIDENT) |
| Authorized Official Contact | 6192919285 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alex J. Mercandetti, M.d., Inc. A Professional Corporation 4060 Fourth Ave Suite 335 San Diego CA 92103-2116 Ph: (619) 291-9285 | Alex J. Mercandetti, M.d., Inc. A Professional Corporation 4060 Fourth Ave Suite 335 San Diego CA 92103-2116 Ph: (619) 291-9285 |
| NPI Number | 1831126317 |
|---|---|
| Provider Enumeration Date | 06/28/2006 |
| Last Update Date | 01/05/2016 |
| Medicare PECOS PAC ID | 6709812779 |
|---|---|
| Medicare Enrollment ID | O20050711000821 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831126317 | NPI | - | NPPES |
| GR0084400 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G41199 (California) | Primary |
| Provider Name | Alex J Mercandetti |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1588691455 PECOS PAC ID: 9335051028 Enrollment ID: I20040616001581 |
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