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>> Anesthesiology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1215946363

Individual Registrant:
Gender: M
Not Sole Proprietor

Location and contact information for practice:
Tel: 540-829-4100  Fax: --

Contact information for business:
PO BOX 7096  STOCKTON, CA 95267-0096 US
Tel: 209-956-7725  Fax: 209-956-7733

Registration Information:
NPI: 1215946363
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207L00000XAllopathic & Osteopathic Physicians
N207R00000XAllopathic & Osteopathic Physicians
Internal Medicine

Legacy codes, insurance codes and state license numbers:



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