Individual
DR. SUNNY KOIPURATHU PHILIP JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 S HAM LN STE S, LODI, CA 95242-7503
(209) 366-2616
(209) 333-3884
Mailing address
2626 N CALIFORNIA ST STE B, STOCKTON, CA 95204-5500
(209) 466-2626
(209) 466-7153
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
A151375
CA
Other
Enumeration date
04/05/2011
Last updated
02/13/2018
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