Organization
VALLEY MRI AND RADIOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES ALLEN STILLMAN D.O. (OWNER)
(209) 467-1000
Entity
Organization
Contact information
Practice address
546 E PINE ST, STOCKTON, CA 95204-5525
(209) 467-1000
(209) 467-7335
Mailing address
546 E PINE ST, STOCKTON, CA 95204-5525
(209) 467-1000
(209) 467-7335
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
C35905
CA
2085R0202X
Diagnostic Radiology Physician
C35905
CA
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
06/01/2011
Last updated
11/03/2016
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