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999 S Fairmont Ave Suite 100 Lodi CA 95240-5100 | |
(209) 334-2010 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 999 S Fairmont Ave, Lodi, California |
Authorized Official Name and Position | Joseph P Harrington (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 2093343411 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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975 S Fairmont Ave Lodi CA 95240-5118 Ph: (209) 334-3411 | 999 S Fairmont Ave Suite 100 Lodi CA 95240-5100 Ph: (209) 334-2010 |
NPI Number | 1396018727 |
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Provider Enumeration Date | 02/15/2012 |
Last Update Date | 10/02/2012 |
Identifier | Type | State | Issuer |
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1396018727 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (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 |