Organization
STOCKTON ORTHOPEDIC MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANA VALDEZ (ADMINISTRATOR)
(209) 948-1641
Entity
Organization
Contact information
Practice address
1901 N CALIFORNIA ST, STOCKTON, CA 95204-6005
(209) 948-1641
(209) 948-0660
Mailing address
1901 N CALIFORNIA ST, STOCKTON, CA 95204-6005
(209) 948-1641
(209) 948-0660
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0219850005
CIGNA MEDICARE PIN
CA
Enumeration date
07/07/2006
Last updated
11/14/2008
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