Individual
DR. JOHN LAWRENCE DEPOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1801 E MARCH LN, SUITE C300, STOCKTON, CA 95210-6629
(209) 948-1425
(209) 464-0193
Mailing address
1801 E MARCH LANE, SUITE C300, STOCKTON, CA 95210-6629
(209) 948-1425
(209) 464-0193
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
A22978
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A229780
—
CA
Enumeration date
07/04/2006
Last updated
09/19/2007
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