# TIMOTHY J SLOAN MD, A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104897362
- **Authorized official:** MR. TIMOTHY J SLOAN MD (MD)
- **Authorized official phone:** (209) 339-9036

## Contact information

- **Practice address:** 1800 N CALIFORNIA ST, STOCKTON, CA 95204
- **Practice address phone:** (209) 943-2000
- **Mailing address:** PO BOX 986, WOODBRIDGE, CA 95258-0986
- **Mailing address phone:** (209) 339-9036
- **Mailing address fax:** (209) 339-1901

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | G35657 | CA | Yes |

## Other

- **Enumeration date:** 01/27/2006
- **Last updated:** 08/04/2008