# EDWARD CHOCK MD INC

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

## Provider details

- **NPI number:** 1548254212
- **Authorized official:** EDWARD CHOCK MD (PRESIDENT)
- **Authorized official phone:** (209) 847-2201

## Contact information

- **Practice address:** 1390 W H ST, STE B, OAKDALE, CA 95361-3570
- **Practice address phone:** (209) 847-2201
- **Practice address fax:** (209) 847-0975
- **Mailing address:** PO BOX 396, OAKDALE, CA 95361-0396
- **Mailing address phone:** (209) 847-2201
- **Mailing address fax:** (209) 847-0975

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | G13634 | CA | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | G37486 | CA | — |

## Other

- **Enumeration date:** 09/08/2005
- **Last updated:** 04/28/2015