Individual
ABASI BOMANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2545 W HAMMER LN, STOCKTON, CA 95209-2839
(213) 226-7443
Mailing address
2545 W HAMMER LN, STOCKTON, CA 95209-2839
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
180702
CA
261QU0200X
Urgent Care Clinic/Center
Primary
A180702
CA
Other
Enumeration date
04/01/2019
Last updated
02/05/2024
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