Provider Demographics
NPI:1902997984
Name:MERCED TURLOCK NEPHROLOGY MED GROUP INC.
Entity Type:Organization
Organization Name:MERCED TURLOCK NEPHROLOGY MED GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD / OWNER
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
Mailing Address - Street 2:STE 125
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
Practice Address - Street 2:STE 125
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:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0100620Medicaid
CAZZZ01629ZMedicare PIN