# NATHAN A. KLUDT, MD, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Plastic Surgery Center of Stockton
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144670597
- **Authorized official:** DR. NATHAN ANDREW KLUDT MD (PRESIDENT)
- **Authorized official phone:** (209) 870-7100

## Contact information

- **Practice address:** 1805 N CALIFORNIA ST STE 405, STOCKTON, CA 95204-6033
- **Practice address phone:** (209) 870-7100
- **Practice address fax:** (209) 870-7116
- **Mailing address:** 1805 N CALIFORNIA ST STE 405, STOCKTON, CA 95204-6033
- **Mailing address phone:** (209) 870-7100
- **Mailing address fax:** (209) 870-7116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | A110013 | CA | Yes |

## Other

- **Enumeration date:** 06/16/2016
- **Last updated:** 06/16/2016