Mertens, Lydia Hasbrouck
Mertens, Lydia Hasbrouck is an individual health care provider with primary practice located at 6800 Palm Avenue Suite C , Sebastopol CA 95472. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Mertens, Lydia Hasbrouck can be contacted via phone (707) 824-9999.Contact Information
Primary practice address
6800 Palm Avenue Suite C
Sebastopol CA 95472
Phone: (707) 824-9999
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | G61214 | California |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | G61214 | California |
Profile Details
| NPI number | 1366592172 |
|---|---|
| LBN Legal business name | Mertens, Lydia Hasbrouck |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 12th, 2007 |
| Last updated | Dec 21st, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366592172 | NPPES |
| California | MEDICAID | 00G612140 |
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