Individual
MAI T LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3132 W MARCH LN STE 5, STOCKTON, CA 95219-2354
(209) 475-5500
(209) 475-5515
Mailing address
1800 HARRISON ST FL 7, OAKLAND, CA 94612-3466
(510) 625-4101
(877) 738-4262
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A98060
CA
208M00000X
Hospitalist Physician
Primary
A98060
CA
Other
Enumeration date
04/10/2007
Last updated
12/21/2021
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