Lodi Memorial Primary Care Clinic | |
2415 W Vine St Ste 105 Lodi CA 95242-3731 | |
(209) 333-3121 | |
(209) 339-7659 |
Full Name | Lodi Memorial Primary Care Clinic |
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Speciality | Clinic/center - Primary Care |
Location | 2415 W Vine St Ste 105, Lodi, California |
Authorized Official Name and Position | Jason Whitney (FINANCE OFFICER) |
Authorized Official Contact | 2093397477 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lodi Memorial Primary Care Clinic Po Box 884577 Los Angeles CA 90088-4577 Ph: (209) 334-3411 | Lodi Memorial Primary Care Clinic 2415 W Vine St Ste 105 Lodi CA 95242-3731 Ph: (209) 333-3121 |
NPI Number | 1306855523 |
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Provider Enumeration Date | 08/05/2006 |
Last Update Date | 01/06/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306855523 | NPI | - | NPPES |
ZZZ53358Z | Other | CA | BLUE SHIELD PROV GRP |
GR0086832 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 030000056 (California) | Primary |
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 |