PACIFIC HEART AND VASCULAR MEDICAL GROUP

LODI, CA
NPI1790712990
Entity TypeOrganization
Authorized ContactKATHERINE BOHNA
Supervisor
209-464-3615
Organization Subpart ?No
Primary Taxonomy207RC0000X Internal Medicine, Cardiovascular Disease
(Licence: CA  FNP33233)
Enumeration Date2006-06-26
Last Update Date2020-03-02
Business Address
PACIFIC HEART AND VASCULAR MEDICAL GROUP
845 S FAIRMONT AVE SUITE 11
LODI, CA 95240-5113
Phone number: 209-334-0651
Mailing Address
PACIFIC HEART AND VASCULAR MEDICAL GROUP
1801 E MARCH LN SUITE D400
STOCKTON, CA 95210-6629
Phone number: 209-464-3615