Provider Demographics
NPI:1144515792
Name:MERINO, FAITH CHERYLE ABALOS (MD)
Entity type:Individual
Prefix:DR
First Name:FAITH CHERYLE
Middle Name:ABALOS
Last Name:MERINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:FAITH
Other - Middle Name:CHERYLE
Other - Last Name:ABALOS-MERINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:15 BONNY DOONE
Mailing Address - Street 2:
Mailing Address - City:HERCULES
Mailing Address - State:CA
Mailing Address - Zip Code:94547-3947
Mailing Address - Country:US
Mailing Address - Phone:714-875-9367
Mailing Address - Fax:
Practice Address - Street 1:1301 PINOLE VALLEY RD
Practice Address - Street 2:
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-1384
Practice Address - Country:US
Practice Address - Phone:510-243-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME110135207Q00000X
CAC138791207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine