NPI: 1609020569
Provider Name: DIGNITY HEALTH MEDICAL FOUNDATION
Doing Business As: DIGNITY HEALTH MEDICAL GROUP - STOCKTON, A SERVICE OF DIGNITY HEALTH M
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization
Specialization: Multi-Specialty
CLIA Number: 05D2008727
Address:
534 E PINE ST
SUITE B
STOCKTON, CA
ZIP 95204
Phone: (209) 466-1980
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DIGNITY HEALTH MEDICAL FOUNDATION is a multi-specialty clinic center in Stockton, CA. DIGNITY HEALTH MEDICAL FOUNDATION NPI is 1609020569. The provider is registered as an organization entity type.
The provider Is Doing Business As Dignity Health Medical Group - Stockton, A Service Of Dignity Health M.
The provider's business location address is:
534 E PINE ST
SUITE B
STOCKTON, CA
ZIP 95204-536
Phone: (209) 466-1980
Fax: (209) 466-1982
The provider's authorized official is Theresa M Hylen .
The authorized official title is Chief Financial Officer and has the following contact phone number (916) 851-2559.
The CLIA number assigned to this NPI record is 05D2008727 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).
The enumeration date for this NPI number is 11/5/2008 and was last updated on 11/18/2020.