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Organization
PEDIATRIC ASSOCIATES OF STOCKTON
Active
Organization
PEDIATRIC ASSOCIATES OF STOCKTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUE ZUMWALT (OFFICE ADMINISTRATOR)
(209) 870-2724
Entity
Organization
Contact information
Practice address
89 W MARCH LN, SUITE #1, STOCKTON, CA 95207-5723
(209) 478-2622
(209) 870-2754
Mailing address
89 W MARCH LN, SUITE #1, STOCKTON, CA 95207-5723
(209) 478-2622
(209) 870-2754
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ557612
BLUE CROSS
CA
Enumeration date
08/24/2005
Last updated
08/22/2020
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