Individual
EILEEN P PRIMERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2505 W HAMMER LN, STOCKTON, CA 95209-2839
(209) 957-7050
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
C50284
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C502840
—
CA
Enumeration date
04/20/2006
Last updated
06/17/2010
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