Organization
DAMERON HOSPITAL ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM KENNETH CHASE (CONTROLLER)
(209) 461-3193
Entity
Organization
Contact information
Practice address
525 W ACACIA ST, STOCKTON, CA 95203-2405
(209) 944-5550
Mailing address
525 W ACACIA ST, STOCKTON, CA 95203-2405
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
030000024
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HCP40122F
—
CA
05
—
HCS00122F
—
CA
Enumeration date
06/01/2005
Last updated
08/21/2024
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