Individual
PAO CHOUA VANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 N EL DORADO ST, STOCKTON, CA 95202-1305
(209) 938-0228
(209) 938-0281
Mailing address
1111 N EL DORADO ST, STOCKTON, CA 95202-1305
(209) 938-0228
(209) 938-0281
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
01/19/2007
Last updated
07/08/2007
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