Individual
JOSE C. MAYORGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2062 E SONORA ST, STOCKTON, CA 95205-6323
(408) 792-2100
Mailing address
2062 E SONORA ST, STOCKTON, CA 95205-6323
(669) 350-5289
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
282N00000X
General Acute Care Hospital
7474657
CA
Other
Enumeration date
06/25/2015
Last updated
08/12/2016
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