| |
1545 Saint Marks Plz Ste 1 Stockton CA 95207-6411 | |
(209) 957-1244 | |
(209) 957-2591 |
Full Name | |
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Speciality | Durable Medical Equipment & Medical Supplies |
Location | 1545 Saint Marks Plz Ste 1, Stockton, California |
Authorized Official Name and Position | Rommel Kaur Bal (PRESIDENT) |
Authorized Official Contact | 2099571244 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1545 Saint Marks Plz Ste 1 Stockton CA 95207-6411 Ph: (209) 957-1244 | 1545 Saint Marks Plz Ste 1 Stockton CA 95207-6411 Ph: (209) 957-1244 |
NPI Number | 1649746066 |
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Provider Enumeration Date | 10/23/2018 |
Last Update Date | 07/22/2020 |
Medicare PECOS PAC ID | 7517205602 |
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Medicare Enrollment ID | O20190215000396 |
Identifier | Type | State | Issuer |
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1649746066 | NPI | - | NPPES |
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