| Pacific Wound Center Medical Group, Inc. | |
|
4722 Quail Lakes Dr Suite A Stockton CA 95207-5256 | |
| (209) 476-0675 | |
| (209) 476-9389 |
| Full Name | Pacific Wound Center Medical Group, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 4722 Quail Lakes Dr, Stockton, California |
| Authorized Official Name and Position | William D. Mcdonald (OWNER/AUTHORIZED OFFICIAL,(PER PECO) |
| Authorized Official Contact | 2094760675 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Wound Center Medical Group, Inc. 4722 Quail Lakes Dr Suite A Stockton CA 95207-5256 Ph: (209) 476-0675 | Pacific Wound Center Medical Group, Inc. 4722 Quail Lakes Dr Suite A Stockton CA 95207-5256 Ph: (209) 476-0675 |
| NPI Number | 1659399202 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 11/23/2015 |
| Medicare PECOS PAC ID | 2163419581 |
|---|---|
| Medicare Enrollment ID | O20040428000524 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659399202 | NPI | - | NPPES |
| ZZZ07794Z | Other | CA | BLUE SHIELD |
| ZZZ07794Z | Other | BLUE SHIELD |
| Provider Name | Annette Maria Seiler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629008339 PECOS PAC ID: 9133109291 Enrollment ID: I20040721000439 |
| Provider Name | Kenneth Ken Shimozaki |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1053429027 PECOS PAC ID: 7416056205 Enrollment ID: I20070619000684 |
| Provider Name | Surrender Raina |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1184662165 PECOS PAC ID: 1759322589 Enrollment ID: I20080606000348 |
| Provider Name | Parminder P Jagur |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1083053342 PECOS PAC ID: 1153634357 Enrollment ID: I20150716002842 |
| Provider Name | Xingbo P Sun |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1841639200 PECOS PAC ID: 9931491487 Enrollment ID: I20160701001759 |
| Provider Name | Seiha Thorng |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1104100221 PECOS PAC ID: 1052532785 Enrollment ID: I20161220002429 |
| Provider Name | Jonathan M Deguzman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1962820597 PECOS PAC ID: 4688941222 Enrollment ID: I20170601002012 |
| Provider Name | Joshua B Stauffer |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1356710974 PECOS PAC ID: 9133468663 Enrollment ID: I20191125001773 |
| Provider Name | Daniel K Kim |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1427581016 PECOS PAC ID: 0941578447 Enrollment ID: I20200921000922 |
James H. Holmes, Jr., M.d., Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1502 St. Mark's Plaza, Suite 5, Stockton, CA 95207 Phone: 209-466-8683 Fax: 209-466-8309 | |
Aziz Kamali Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1947 N California St Ste A, Stockton, CA 95204 Phone: 209-478-5533 Fax: 209-475-0187 | |
Dameron Medical Group, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 530 W Acacia St, Stockton, CA 95203 Phone: 209-461-3196 Fax: 209-461-7593 | |
Kulendu G Vasavda Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 221 Tuxedo Court, Suite B, Stockton, CA 95204 Phone: 209-941-0149 Fax: 209-941-2550 | |
Ht Family Physicians, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 77 W March Ln, Suite A, Stockton, CA 95207 Phone: 209-477-5552 Fax: 209-477-5553 | |
San Joaquin County Clinics Chs Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1414 N California St Suite A, Stockton, CA 95202 Phone: 209-953-6400 Fax: 209-468-2321 | |
American Current Care Of California, A Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 702 W Hammer Ln, Stockton, CA 95210 Phone: 209-546-7767 Fax: 209-546-7785 |