Organization
DAMERON HOSPITAL ASSOCIATION
Active
Parent organization
DAMERON HOSPITAL ASSOCIATIONI
Other names
Ambulatory Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAMERON HOSPITAL ASSOCIATIONI
Authorized official
MS. LORRAINE P. AUERBACH (PRESIDENT & CEO)
(209) 461-3100
Entity
Organization
Contact information
Practice address
530 W ACACIA ST, SUITE 1, STOCKTON, CA 95203-2454
(209) 944-5410
(209) 944-5477
Mailing address
525 W. ACACIA STREET, ATTN: FINANCE DEPARTMENT, STOCKTON, CA 95203-2484
(209) 461-3148
(209) 461-3130
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05-0122
MEDICARE ID-TYPE UNSPECIFIED
—
Enumeration date
04/23/2014
Last updated
04/24/2014
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