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2407 W Vine St Suite A Lodi CA 95242-3730 | |
(209) 334-3411 | |
(209) 339-7659 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 2407 W Vine St, Lodi, California |
Authorized Official Name and Position | Joseph P Harrington (CHEIF EXECUTIVE OFFICER & PRESIDENT) |
Authorized Official Contact | 2093343411 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 3004 Lodi CA 95241-1908 Ph: (209) 334-3411 | 2407 W Vine St Suite A Lodi CA 95242-3730 Ph: (209) 334-3411 |
NPI Number | 1023256880 |
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Provider Enumeration Date | 01/30/2009 |
Last Update Date | 01/07/2011 |
Identifier | Type | State | Issuer |
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1023256880 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (California) | 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 |