Organization
LODI UROLOGICAL MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
N. ERICK ALBERT M.D. (PRESIDENT)
(209) 368-6661
Entity
Organization
Contact information
Practice address
830 S HAM LN, SUITE 26, LODI, CA 95242-7510
(209) 368-6661
(209) 333-7655
Mailing address
830 S HAM LN, SUITE 26, LODI, CA 95242-7510
(209) 368-6661
(209) 333-7655
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1016910001
DMERC/NORIDIAN
CA
05
—
ZZZ77184Z
—
CA
Enumeration date
10/05/2006
Last updated
04/29/2008
Update your record
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