Mercy Gate Foundation
Internal Medicine in Scotts Valley, CA. Organization (NPI-2).
NPI number1003608902
StatusActive
Last updated in NPPESMay 19, 2025
Details
- NPI
- 1003608902
- Entity type
- Organization (NPI-2)
- Legal business name
- Mercy Gate Foundation
- Organization subpart
- No
- Enumeration date
- May 19, 2025
- Certification date
- May 19, 2025
- Last updated
- May 19, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
Practice location
1580 Lockhart Gulch RdScotts Valley, CA 95066-2917
Phone 541-908-2316
Mailing address
2108 N St # 6539Sacramento, CA 95816-5712
Authorized official
Aly Mohamed
Ceo
5419082316
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