Organization
VITREO-RETINAL MEDICAL GROUP, INC.
Active
Other names
Retina Center of Stockton, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOEL PEARLMAN MD (PRESIDENT)
(916) 596-2027
Entity
Organization
Contact information
Practice address
3555 DEER PARK DR, SUITE 180, STOCKTON, CA 95219-2377
(209) 938-0496
(209) 951-5231
Mailing address
3 PARK CENTER DR STE 100, SACRAMENTO, CA 95825-8340
(916) 514-5469
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0199873
DEPT OF LABOR WA
WA
01
—
CP5300
RAILROAD MEDI-CARE
CA
05
—
GR0030322
—
CA
01
—
ZZZ14095Z
BLUE SHIELD CA
CA
Enumeration date
10/02/2006
Last updated
10/06/2023
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