Individual
DAVID GLEN MORDECAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8686
Mailing address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8686
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/28/2008
Last updated
07/28/2008
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