# STOCKTON ORTHOPEDIC MEDICAL GROUP, INC.

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

## Provider details

- **NPI number:** 1285666743
- **Authorized official:** JANA VALDEZ (ADMINISTRATOR)
- **Authorized official phone:** (209) 948-1641

## Contact information

- **Practice address:** 1901 N CALIFORNIA ST, STOCKTON, CA 95204-6005
- **Practice address phone:** (209) 948-1641
- **Practice address fax:** (209) 948-0660
- **Mailing address:** 1901 N CALIFORNIA ST, STOCKTON, CA 95204-6005
- **Mailing address phone:** (209) 948-1641
- **Mailing address fax:** (209) 948-0660

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | CA | Yes |

## Other

- **Enumeration date:** 07/07/2006
- **Last updated:** 11/14/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0219850005 | CIGNA MEDICARE PIN | CA |