Organization
LODI MEMORIAL HOSPITAL ASSOCIATION INC
Active
Parent organization
LODI MEMORIAL HOSPITAL ASSOCIATION INC
Other names
Adventist Health Lodi Memorial, AH Medical Office Galt, Lodi Health Physicians Galt Family and Specialty Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
LODI MEMORIAL HOSPITAL ASSOCIATION INC
Authorized official
JASON WHITNEY (FINANCE OFFICER)
(209) 339-7477
Entity
Organization
Contact information
Practice address
387 CIVIC DR, GALT, CA 95632-2059
(209) 745-8080
(209) 745-8081
Mailing address
PO BOX 884577, LOS ANGELES, CA 90088-4577
(209) 334-3411
(209) 339-7659
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
030000056
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHM18546F
—
CA
01
—
ZZZ53360Z
BLUE SHIELD PROV GRP
CA
Enumeration date
08/05/2006
Last updated
04/01/2022
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