Organization
LODI CHILDREN'S CLINIC MEDICAL CORPORATION
Active
Other names
LODI CHILDREN'S CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY ANUNCIACION (PRESIDENT)
(209) 368-8310
Entity
Organization
Contact information
Practice address
1920 TIENDA DR, SUITE 102, LODI, CA 95242-3930
(209) 368-8310
(209) 368-9652
Mailing address
1920 TIENDA DR, SUITE 102, LODI, CA 95242-3930
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/19/2006
Last updated
08/22/2020
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