Organization
CENTER FOR SIGHT OF STOCKTON A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP E EDINGTON MD (DIRECTOR)
(209) 948-5515
Entity
Organization
Contact information
Practice address
612 W 11TH ST, SUITE 103, TRACY, CA 95376-3855
(209) 836-4800
(209) 836-3917
Mailing address
1899 W. MARCH LANE, STOCKTON, CA 95207-6402
(209) 623-4700
(209) 623-4713
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ26803Z
GROUP PTAN
CA
Enumeration date
07/27/2006
Last updated
09/01/2017
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