| Lodi Memorial Community Clinic - Iris | |
|
801 S Ham Lane Suite S Lodi CA 95242-7501 | |
| (209) 334-3411 | |
| (209) 339-7659 |
| Full Name | Lodi Memorial Community Clinic - Iris |
|---|---|
| Speciality | Clinic/Center |
| Location | 801 S Ham Lane, Lodi, California |
| Authorized Official Name and Position | Joseph P Harrington (CHIEF EXECUTIVE OFFICER & PRESIDENT) |
| Authorized Official Contact | 2093343411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lodi Memorial Community Clinic - Iris Po Box 3004 Lodi CA 95241-1908 Ph: (209) 334-3411 | Lodi Memorial Community Clinic - Iris 801 S Ham Lane Suite S Lodi CA 95242-7501 Ph: (209) 334-3411 |
| NPI Number | 1861649352 |
|---|---|
| Provider Enumeration Date | 08/26/2008 |
| Last Update Date | 01/07/2011 |
| Medicare PECOS PAC ID | 7618880717 |
|---|---|
| Medicare Enrollment ID | O20050517000577 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861649352 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (California) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | 550000838 (California) | Primary |
| Provider Name | Nanying Li |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750498309 PECOS PAC ID: 2860397056 Enrollment ID: I20031201000731 |
| Provider Name | Juk L Ting |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699713974 PECOS PAC ID: 3779486204 Enrollment ID: I20040301001214 |
| Provider Name | Kenneth H Mullen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922065721 PECOS PAC ID: 1850288036 Enrollment ID: I20040302001025 |
| Provider Name | James J Grady |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629036413 PECOS PAC ID: 8820988637 Enrollment ID: I20040316001390 |
| Provider Name | Lisa H Ellis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245214923 PECOS PAC ID: 5092607291 Enrollment ID: I20040324001768 |
| Provider Name | Mithu Shams Molla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508943432 PECOS PAC ID: 3678568128 Enrollment ID: I20040415000738 |
| Provider Name | Gursharan Nahl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437117322 PECOS PAC ID: 7416944210 Enrollment ID: I20040426000923 |
| Provider Name | Edward Telung Chang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780637199 PECOS PAC ID: 7911980966 Enrollment ID: I20040610000734 |
| Provider Name | John P Connolly |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1821000480 PECOS PAC ID: 7315858883 Enrollment ID: I20040826000731 |
| Provider Name | Beien Shi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538276951 PECOS PAC ID: 5496748402 Enrollment ID: I20040903001088 |
| Provider Name | Harvey J Hashimoto |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578506952 PECOS PAC ID: 4183683022 Enrollment ID: I20041006001451 |
| Provider Name | Nazish N Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932121498 PECOS PAC ID: 5890740872 Enrollment ID: I20050314000469 |
| Provider Name | Dawnette C Person |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801809470 PECOS PAC ID: 5193762078 Enrollment ID: I20050412000992 |
| Provider Name | De Tan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1851384044 PECOS PAC ID: 1557303211 Enrollment ID: I20050524000520 |
| Provider Name | James Jason Cooney |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1760450092 PECOS PAC ID: 6002858396 Enrollment ID: I20050526000385 |
| Provider Name | Danielle K Bassett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912963984 PECOS PAC ID: 8729024740 Enrollment ID: I20050629001322 |
| Provider Name | Mark L Hoff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558455618 PECOS PAC ID: 5597701011 Enrollment ID: I20050706000338 |
| Provider Name | Joseph D Gayagoy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386738458 PECOS PAC ID: 5698704849 Enrollment ID: I20050809000305 |
| Provider Name | Nancy Michelle Inforzato |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043362841 PECOS PAC ID: 9638107667 Enrollment ID: I20051215000251 |
| Provider Name | Sarah E Mann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437161643 PECOS PAC ID: 0345264099 Enrollment ID: I20060120000193 |
| Provider Name | Truong Dang Quach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346358223 PECOS PAC ID: 7517962160 Enrollment ID: I20061003000601 |
| Provider Name | Frank T Huang |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1013023274 PECOS PAC ID: 9638175169 Enrollment ID: I20061005000672 |
| Provider Name | Roham Vatanparast |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518151497 PECOS PAC ID: 7214023779 Enrollment ID: I20071012000691 |
| Provider Name | Mohammad Akmal |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1356378087 PECOS PAC ID: 1557377892 Enrollment ID: I20071129000157 |
| Provider Name | Ilya L Khamishon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275517062 PECOS PAC ID: 5799861597 Enrollment ID: I20080319000305 |
| Provider Name | Narinder S Dhaliwal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639175581 PECOS PAC ID: 9133207269 Enrollment ID: I20080415000491 |
| Provider Name | Edmund A Freund |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740237155 PECOS PAC ID: 7315920824 Enrollment ID: I20080703000602 |
| Provider Name | Lidia E Everett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700976024 PECOS PAC ID: 5991722266 Enrollment ID: I20080723000387 |
| Provider Name | Rajbarinder S Hundal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1720266059 PECOS PAC ID: 1850459892 Enrollment ID: I20081021000318 |
| Provider Name | Jorge A Oceguera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659384212 PECOS PAC ID: 2668533019 Enrollment ID: I20081204000344 |
| Provider Name | Craig Steven Garfolo |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1629028923 PECOS PAC ID: 9830250653 Enrollment ID: I20081211000244 |
| Provider Name | Eva Y Lew |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558322347 PECOS PAC ID: 6406918689 Enrollment ID: I20081223000007 |
| Provider Name | Mark R Rose |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427055102 PECOS PAC ID: 8729163233 Enrollment ID: I20090601000299 |
| Provider Name | Min M Hlaing |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518122449 PECOS PAC ID: 2961553763 Enrollment ID: I20090707000321 |
| Provider Name | Mohiuddin Waseem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669527594 PECOS PAC ID: 3971529389 Enrollment ID: I20091021000823 |
| Provider Name | Robert B Eisenberg |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1821014820 PECOS PAC ID: 8921181199 Enrollment ID: I20100422000943 |
| Provider Name | Theressia Louise Washington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992951347 PECOS PAC ID: 2668667452 Enrollment ID: I20101105000729 |
| Provider Name | Wei Fan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053499863 PECOS PAC ID: 4284820903 Enrollment ID: I20101119001209 |
| Provider Name | Marian Te Selle |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1932287695 PECOS PAC ID: 8527257708 Enrollment ID: I20110104001276 |
| Provider Name | Hassanali Mohamedali |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1598984809 PECOS PAC ID: 0446449375 Enrollment ID: I20110107000793 |
| Provider Name | Alice M Zapp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932212008 PECOS PAC ID: 3577742600 Enrollment ID: I20110121000451 |
| Provider Name | Nazir J Habib |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1033261250 PECOS PAC ID: 4587843164 Enrollment ID: I20110128000104 |
| Provider Name | Thomas C Kreck |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1457439200 PECOS PAC ID: 6901080415 Enrollment ID: I20110407000438 |
| Provider Name | Efrain Talamantes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063688802 PECOS PAC ID: 5890972772 Enrollment ID: I20110601000410 |
| Provider Name | Sanjiv M Kaul |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1588659247 PECOS PAC ID: 0345383139 Enrollment ID: I20110808000284 |
| Provider Name | Teresa Vaccarezza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952414013 PECOS PAC ID: 0345411682 Enrollment ID: I20110919000491 |
| Provider Name | Ranganathan G Madhavan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043355019 PECOS PAC ID: 5193811701 Enrollment ID: I20111220000718 |
| Provider Name | Norman Dagobert Schmidt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417037250 PECOS PAC ID: 0840467486 Enrollment ID: I20120123000065 |
| Provider Name | Rolando G Simeon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457344293 PECOS PAC ID: 6709046519 Enrollment ID: I20120330000570 |
| Provider Name | Voltaire R Sinigayan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023245164 PECOS PAC ID: 3870757552 Enrollment ID: I20120608000174 |
| Provider Name | Emily Huang |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1568511061 PECOS PAC ID: 0345425005 Enrollment ID: I20120611000159 |
| Provider Name | Fareen S Rahman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427248954 PECOS PAC ID: 3072637719 Enrollment ID: I20120614000756 |
| Provider Name | Don Fernandez |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1972583755 PECOS PAC ID: 7810904695 Enrollment ID: I20120726000507 |
| Provider Name | David Nabil Sorour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588984330 PECOS PAC ID: 3870749070 Enrollment ID: I20120803000072 |
| Provider Name | Randall G Lorenz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669430955 PECOS PAC ID: 9335179134 Enrollment ID: I20120808000587 |
| Provider Name | Schonze F Del Pozo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063547461 PECOS PAC ID: 9133245350 Enrollment ID: I20121228000080 |
| Provider Name | Katherine Redmond-larimer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831468255 PECOS PAC ID: 0042463580 Enrollment ID: I20130110000606 |
| Provider Name | Chuen-fu Lin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043328818 PECOS PAC ID: 2365695624 Enrollment ID: I20130117000110 |
| Provider Name | Lingamurthy Ravi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679542120 PECOS PAC ID: 9739160987 Enrollment ID: I20130125000002 |
| Provider Name | Kourosh Khamooshian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659523975 PECOS PAC ID: 9133253958 Enrollment ID: I20130502000050 |
| Provider Name | Jacqueline S Craig |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1568752152 PECOS PAC ID: 8921248030 Enrollment ID: I20130715000355 |
| Provider Name | Richard Sevilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932285921 PECOS PAC ID: 1557501491 Enrollment ID: I20130717000311 |
| Provider Name | Ali Jamshidi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154438372 PECOS PAC ID: 0941227359 Enrollment ID: I20130717000592 |
| Provider Name | Reza Bashtar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285868729 PECOS PAC ID: 8325289366 Enrollment ID: I20130802000332 |
| Provider Name | Xing Gao |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659490944 PECOS PAC ID: 2163694811 Enrollment ID: I20131105000982 |
| Provider Name | Venkat Tirumala |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1659491298 PECOS PAC ID: 3274630835 Enrollment ID: I20131121001310 |
| Provider Name | Christie E Campbell |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1851597215 PECOS PAC ID: 3375792658 Enrollment ID: I20131126000620 |
| Provider Name | Catherine V Carroll |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952627937 PECOS PAC ID: 3577799204 Enrollment ID: I20131202000532 |
| Provider Name | Juliene Gentry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144205329 PECOS PAC ID: 8426058140 Enrollment ID: I20131205001732 |
| Provider Name | Ryan E Vaccarezza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982037040 PECOS PAC ID: 8224266440 Enrollment ID: I20140116000011 |
| Provider Name | Daryl L Chestney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023229457 PECOS PAC ID: 5597881821 Enrollment ID: I20140422001048 |
| Provider Name | Ramya Mallareddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952609430 PECOS PAC ID: 2365669769 Enrollment ID: I20140808000008 |
| Provider Name | Brittanie K Tovar |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1922415660 PECOS PAC ID: 1759500259 Enrollment ID: I20140916000667 |
| Provider Name | Kathi S Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689017972 PECOS PAC ID: 7113147109 Enrollment ID: I20140924002629 |
| Provider Name | Pablo R Castro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538422316 PECOS PAC ID: 5799906178 Enrollment ID: I20141028002964 |
| Provider Name | Olaseni Alexander Shoroye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053376509 PECOS PAC ID: 1557346418 Enrollment ID: I20150313001140 |
| Provider Name | Aarti K Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831507052 PECOS PAC ID: 4981921533 Enrollment ID: I20150319002760 |
| Provider Name | Daniel A Okamoto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073803979 PECOS PAC ID: 4688890973 Enrollment ID: I20150701002541 |
| Provider Name | Jaynesh A Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255633038 PECOS PAC ID: 3072826114 Enrollment ID: I20150720001015 |
| Provider Name | Zubin Udwadia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922364967 PECOS PAC ID: 7618282047 Enrollment ID: I20150814012690 |
| Provider Name | Harpreet Singh Parmar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063690717 PECOS PAC ID: 3779772256 Enrollment ID: I20150818003695 |
| Provider Name | Chandana Bommireddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356665293 PECOS PAC ID: 6305078833 Enrollment ID: I20150819008730 |
| Provider Name | Hana N Abuershaid |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1497164016 PECOS PAC ID: 4880900232 Enrollment ID: I20150831000744 |
| Provider Name | Kristen C Macrae |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184007015 PECOS PAC ID: 9739495151 Enrollment ID: I20150831003016 |
| Provider Name | Christopher Voscopoulos |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1942475538 PECOS PAC ID: 9739358698 Enrollment ID: I20150911000830 |
| Provider Name | Charles C Shang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104805902 PECOS PAC ID: 0840239497 Enrollment ID: I20150916003083 |
| Provider Name | Victoria Laine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609134006 PECOS PAC ID: 9032427497 Enrollment ID: I20151005001044 |
| Provider Name | Uzoma Raymond Chukwu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255741567 PECOS PAC ID: 7911216940 Enrollment ID: I20151014001319 |
| Provider Name | Manreet Basra |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1114157484 PECOS PAC ID: 2567605900 Enrollment ID: I20151022001122 |
| Provider Name | Paramvir Singh |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346213444 PECOS PAC ID: 8022081652 Enrollment ID: I20151207002499 |
| Provider Name | Ruby K Gill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609147354 PECOS PAC ID: 6507184488 Enrollment ID: I20151222000793 |
| Provider Name | Manny C Zewdu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881956886 PECOS PAC ID: 3375844533 Enrollment ID: I20151223000571 |
| Provider Name | Rawel S Randhawa |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1689781361 PECOS PAC ID: 4789602715 Enrollment ID: I20160209002667 |
| Provider Name | Bruce M Espenshade |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265655237 PECOS PAC ID: 3072677095 Enrollment ID: I20160524000534 |
| Provider Name | Srinivasa K Srinidhi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1376800730 PECOS PAC ID: 5991097685 Enrollment ID: I20160718001415 |
| Provider Name | Abdul W Raif Jawid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245672815 PECOS PAC ID: 8426347360 Enrollment ID: I20160920000719 |
| Provider Name | Brandon Murguia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821325770 PECOS PAC ID: 0941422828 Enrollment ID: I20160928000891 |
| Provider Name | Gurjit Singh Sivia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225474836 PECOS PAC ID: 2365720133 Enrollment ID: I20161028001581 |
| Provider Name | Daisy Briseno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891151023 PECOS PAC ID: 8527348978 Enrollment ID: I20161201001063 |
| Provider Name | Anvita Sinha |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1467463422 PECOS PAC ID: 8729154679 Enrollment ID: I20161213001317 |
| Provider Name | Mohammad Albaba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861589962 PECOS PAC ID: 0345331153 Enrollment ID: I20170112001316 |
| Provider Name | Melvin De La Cruz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346681293 PECOS PAC ID: 3173805926 Enrollment ID: I20170131001695 |
| Provider Name | Frank B Adams |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508841180 PECOS PAC ID: 1658477120 Enrollment ID: I20170406000393 |
| Provider Name | Joseph K Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194906107 PECOS PAC ID: 9234230954 Enrollment ID: I20170412002215 |
| Provider Name | Rajeev K Samuel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639437965 PECOS PAC ID: 6608143540 Enrollment ID: I20170525001304 |
| Provider Name | Kelly R Shannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265886071 PECOS PAC ID: 4981986999 Enrollment ID: I20170622000771 |
| Provider Name | Haytham Aljoudi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699969287 PECOS PAC ID: 9436246352 Enrollment ID: I20170911002983 |
| Provider Name | Fahad Aftab |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912317421 PECOS PAC ID: 1951668029 Enrollment ID: I20171127003327 |
| Provider Name | Raj K Batra |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1841302122 PECOS PAC ID: 7416219829 Enrollment ID: I20180323000723 |
| Provider Name | Mona Batra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053304634 PECOS PAC ID: 1658319876 Enrollment ID: I20180504002209 |
| Provider Name | Gaurav Datta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225184765 PECOS PAC ID: 7113093055 Enrollment ID: I20180822001727 |
| Provider Name | Mindy E Tittiger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023350501 PECOS PAC ID: 1456661008 Enrollment ID: I20181010000878 |
| Provider Name | James K Nozaki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437228541 PECOS PAC ID: 0345236196 Enrollment ID: I20181011001547 |
| Provider Name | Arturo N De Leon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437649779 PECOS PAC ID: 9931451226 Enrollment ID: I20181015003442 |
| Provider Name | Melissa Huynh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710474317 PECOS PAC ID: 5092053017 Enrollment ID: I20190215002090 |
| Provider Name | Lay L Khin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841475019 PECOS PAC ID: 4183786874 Enrollment ID: I20190222000853 |
| Provider Name | Alexander J Nedopil |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1326482142 PECOS PAC ID: 5092045476 Enrollment ID: I20190927000732 |
| Provider Name | Tariq A Shaheed |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467802546 PECOS PAC ID: 3577992023 Enrollment ID: I20200403000885 |
| Provider Name | Bader Abu Ghalyoun |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1740492214 PECOS PAC ID: 9830284165 Enrollment ID: I20200716003156 |
| Provider Name | Hingwan Yu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861790487 PECOS PAC ID: 3072800366 Enrollment ID: I20200721004145 |
| Provider Name | Vanessa Sosa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447847801 PECOS PAC ID: 7517373848 Enrollment ID: I20210310001825 |
| Provider Name | Loui Abdelghani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912161787 PECOS PAC ID: 9931252616 Enrollment ID: I20210716002007 |
| Provider Name | Rajesh Bhargava |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013995802 PECOS PAC ID: 9234020199 Enrollment ID: I20210730001511 |
| Provider Name | Rabeep Grewal |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1174886881 PECOS PAC ID: 0446486070 Enrollment ID: I20210918000121 |
| Provider Name | Lisa Ann Merritt |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1407989973 PECOS PAC ID: 8820020753 Enrollment ID: I20230501001460 |
| Provider Name | Elizabeth R Bender |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619672144 PECOS PAC ID: 7214395052 Enrollment ID: I20230626003496 |
| Provider Name | Alaa Gabi |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1114281524 PECOS PAC ID: 0244479855 Enrollment ID: I20231129003466 |
Lodi Memorial Community Clinic-alder Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2407 W Vine St, Suite A, Lodi, CA 95242 Phone: 209-334-3411 Fax: 209-339-7659 | |
Lodi Ave Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1300 W Lodi Ave, Ste P, Lodi, CA 95242 Phone: 209-366-1990 | |
James S. Hoff, M.d., A Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 999 S Fairmont Ave, Suite 135, Lodi, CA 95240 Phone: 209-224-5719 Fax: 209-691-9521 | |
Cmc, Lodi Vine Family Care, Suite 105 Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2415 W Vine St Ste 105, Lodi, CA 95242 Phone: 209-333-3121 | |
Fairmont Ave Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 999 S Fairmont Ave, #130/135, Lodi, CA 95240 Phone: 209-366-2001 | |
Lodi Memorial Urgent Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1235 W Vine St Ste 20, Lodi, CA 95240 Phone: 209-339-7625 Fax: 209-339-7659 | |
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 |