Organization
COUNTY OF SAN JOAQUIN
Active
Parent organization
COUNTY OF SAN JOAQUIN
Other names
San Joaquin County Clinic Hazelton
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF SAN JOAQUIN
Authorized official
MR. DAVID B JOMAOAS (DIRECTOR OF AMBULATORY CARE SERVICE)
(209) 468-6160
Entity
Organization
Contact information
Practice address
1601 E HAZELTON AVE, STOCKTON, CA 95205-6229
(209) 468-6937
(209) 468-7042
Mailing address
PO BOX 1020, STOCKTON, CA 95201-3120
(209) 468-6937
(209) 468-7042
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
030000087
CA
Other
Enumeration date
10/11/2016
Last updated
06/02/2021
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