Provider Demographics
NPI:1619342854
Name:MERLO, SHAYLI
Entity type:Individual
Prefix:
First Name:SHAYLI
Middle Name:
Last Name:MERLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:892 AEROVISTA PL STE 130
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-8054
Mailing Address - Country:US
Mailing Address - Phone:805-395-3277
Mailing Address - Fax:805-250-4852
Practice Address - Street 1:892 AEROVISTA PL STE 130
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-8054
Practice Address - Country:US
Practice Address - Phone:805-395-3277
Practice Address - Fax:805-250-4852
Is Sole Proprietor?:No
Enumeration Date:2015-12-13
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA179245207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine