| St.josephs Medical Associates Inc. | |
|
1805 N California St Ste 201 Stockton CA 95204-6032 | |
| (209) 939-3840 | |
| (209) 463-4254 |
| Full Name | St.josephs Medical Associates Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1805 N California St Ste 201, Stockton, California |
| Authorized Official Name and Position | Shaukat A Shah (PRESIDENT) |
| Authorized Official Contact | 2099393840 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St.josephs Medical Associates Inc. 1805 N California St Ste 201 Stockton CA 95204-6032 Ph: (209) 939-3840 | St.josephs Medical Associates Inc. 1805 N California St Ste 201 Stockton CA 95204-6032 Ph: (209) 939-3840 |
| NPI Number | 1922010222 |
|---|---|
| Provider Enumeration Date | 08/13/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8123055084 |
|---|---|
| Medicare Enrollment ID | O20050721000877 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922010222 | NPI | - | NPPES |
| ZZZ26105Z | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Shaukat A Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740292028 PECOS PAC ID: 3870648074 Enrollment ID: I20090910000549 |
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