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1920 Tienda Dr Suite 102 Lodi CA 95242-3930 | |
(209) 368-8310 | |
(209) 368-9652 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 1920 Tienda Dr, Lodi, California |
Authorized Official Name and Position | Roy Anunciacion (PRESIDENT) |
Authorized Official Contact | 2093688310 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1920 Tienda Dr Suite 102 Lodi CA 95242-3930 Ph: () - | 1920 Tienda Dr Suite 102 Lodi CA 95242-3930 Ph: (209) 368-8310 |
NPI Number | 1235203688 |
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Provider Enumeration Date | 11/19/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1235203688 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Inpatient Services Of California, Inc., A Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 975 S. Fairmont Ave, Lodi, CA 95240 Phone: 214-712-2400 |