| NPI | 1154352771 |
|---|---|
| Doing Business As | STOCKTON MEDICAL PLAZA PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | STEVEN A MITNICK Medical Director 209-521-6097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA g32207) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA g25105) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA g41310) | |
| 208000000X Pediatrics (Licence: CA a16204) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2012-10-03 |