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Organization

MARCH LANE PEDIATRIC GROUP

Active
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Organization

MARCH LANE PEDIATRIC GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANGE MOUTTAPA M.D. (PHYSICIAN)
(209) 952-5555
Entity
Organization

Contact information

Practice address
73 W MARCH LN STE F, STOCKTON, CA 95207-5726
(209) 952-5555
(209) 952-1907
Mailing address
73 W MARCH LN STE F, STOCKTON, CA 95207-5726
(209) 952-5555
(209) 952-1907

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A25317
CA

Other

Enumeration date
12/06/2012
Last updated
12/06/2012
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