| Woodbridge Medical Group | |
|
2401 W Turner Rd Lodi CA 95242-2182 | |
| (209) 370-1700 | |
| (209) 370-1737 |
| Full Name | Woodbridge Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 2401 W Turner Rd, Lodi, California |
| Authorized Official Name and Position | Michael H Kirkpatrick (CEO) |
| Authorized Official Contact | 2093732833 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodbridge Medical Group Po Box 779 Stockton CA 95201-0779 Ph: (209) 373-2800 | Woodbridge Medical Group 2401 W Turner Rd Lodi CA 95242-2182 Ph: (209) 370-1700 |
| NPI Number | 1881685964 |
|---|---|
| Provider Enumeration Date | 10/28/2005 |
| Last Update Date | 07/14/2010 |
| Medicare PECOS PAC ID | 8426968520 |
|---|---|
| Medicare Enrollment ID | O20100803000991 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881685964 | NPI | - | NPPES |
| FHC70460F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 030000424 (California) | Primary |
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