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Organization
SAN JOAQUIN KIDNEY CLINIC, INC
Active
Organization
SAN JOAQUIN KIDNEY CLINIC, INC
Active
Other names
San Joaquin Kidney Clinic, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. P. B. SAGIREDDY M. D. (OWNER)
(209) 546-1868
Entity
Organization
Contact information
Practice address
1801 E MARCH LN # B-265, STOCKTON, CA 95210-6629
(209) 546-1868
(209) 461-6505
Mailing address
1801 E MARCH LN # B-265, STOCKTON, CA 95210-6629
(209) 546-1868
(209) 461-6505
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A73135
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A731351
—
CA
01
—
DA0971
RAILROAD MEDICARE
CA
Enumeration date
06/10/2006
Last updated
01/29/2025
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