Organization
PSC STOCKTON OUTPATIENT SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHAN ANDREW KLUDT MD (PRESIDENT)
(209) 870-7100
Entity
Organization
Contact information
Practice address
1805 N CALIFORNIA ST, SUITE 405, STOCKTON, CA 95204-6037
(209) 870-7100
(209) 870-7116
Mailing address
1805 N CALIFORNIA ST, SUITE 405, STOCKTON, CA 95204-6037
(209) 870-7100
(209) 870-7116
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A110013
CA
Other
Enumeration date
09/21/2016
Last updated
09/21/2016
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