Organization
LODI ADVANCED MEDICAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN STEWART (AUTHORIZED OFFICIAL)
(209) 368-0619
Entity
Organization
Contact information
Practice address
1420 W KETTLEMAN LN STE K1, LODI, CA 95242-4559
(209) 368-0619
Mailing address
1420 W KETTLEMAN LN STE K1, LODI, CA 95242-4559
(209) 368-0619
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/02/2022
Last updated
03/08/2023
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