Individual
ANDREY MAKSIMTSOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1800 N CALIFORNIA ST, STOCKTON, CA 95204-6019
(209) 943-2000
Mailing address
6132 PALMAYA LN, ORANGEVALE, CA 95662-5903
(864) 999-0209
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA64335
CA
363AM0700X
Medical Physician Assistant
0010-13321
NC
Other
Enumeration date
06/19/2023
Last updated
10/21/2024
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