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Individual

JOSEPH BAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2256 HEAVENLY WAY, LODI, CA 95242-4490
(209) 207-8262
Mailing address
2256 HEAVENLY WAY, LODI, CA 95242-4490
(209) 207-8262

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9954
CA

Other

Enumeration date
10/06/2025
Last updated
10/06/2025
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