Provider Demographics
NPI:1679664643
Name:MERCED TURLOCK NEPHROLOGY
Entity type:Organization
Organization Name:MERCED TURLOCK NEPHROLOGY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NIRMAL
Authorized Official - Middle Name:S
Authorized Official - Last Name:AUJLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-723-1020
Mailing Address - Street 1:3351 M ST 125
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348
Mailing Address - Country:US
Mailing Address - Phone:209-723-1020
Mailing Address - Fax:209-723-6784
Practice Address - Street 1:3351 M ST 125
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348
Practice Address - Country:US
Practice Address - Phone:209-723-1020
Practice Address - Fax:209-723-6784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42706207RN0300X
CA261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACDC 52528FMedicaid
552528Medicare Oscar/Certification
CAE27916Medicare UPIN