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Organization
INDRA DE M.D., INC.
Active
Organization
INDRA DE M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. INDRA DE MD (PRESIDENT)
(209) 462-9100
Entity
Organization
Contact information
Practice address
2333 W MARCH LN STE A1, STOCKTON, CA 95207-5263
(209) 462-9100
(209) 462-9101
Mailing address
3905 GLEN ABBY CIR, STOCKTON, CA 95219-1800
(209) 462-9100
(209) 462-9101
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
C52396
CA
Other
Enumeration date
07/23/2007
Last updated
03/11/2019
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