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Individual

DR. LAURA A. STALLONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1114 6TH ST, MODESTO, CA 95354-2203
(209) 576-2845
(209) 236-1290
Mailing address
737 W CHILDS AVE, MERCED, CA 95340-6805
(209) 383-1848
(209) 383-1296

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A23311
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A233110
BLUE SHIELD OF CA PIN
CA
Enumeration date
11/22/2005
Last updated
03/07/2023
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