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Organization
BIG VALLEY OB-GYN MEDICAL CENTER,INC.
Active
Organization
BIG VALLEY OB-GYN MEDICAL CENTER,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT CHARLES SOUTHMAYD D.O. (PHYSICIAN)
(209) 948-4098
Entity
Organization
Contact information
Practice address
420 W ACACIA ST, SUITE 11, STOCKTON, CA 95203-2441
(209) 948-4098
(209) 948-2334
Mailing address
420 W ACACIA ST, SUITE 11, STOCKTON, CA 95203-2441
(209) 948-4098
(209) 948-2334
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
20A5298
CA
Other
Enumeration date
09/16/2006
Last updated
08/26/2015
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