Individual
INDRA DE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
1800 N CALIFORNIA ST, STOCKTON, CA 95204-6019
(209) 943-2000
Mailing address
3905 GLEN ABBY CIR, STOCKTON, CA 95219-1800
(209) 462-9100
(209) 462-9101
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
C52396
CA
Other
Enumeration date
05/15/2006
Last updated
07/10/2022
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