Individual
SANJEEV KUMAR GOSWAMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1801 E MARCH LANE, STOCKTON, STOCKTON, CA 95210-6676
(209) 464-6422
(209) 464-0193
Mailing address
1801 E MARCH LN, STOCKTON, STOCKTON, CA 95210-6629
(209) 464-6422
(209) 464-0193
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M5308
TX
207RP1001X
Pulmonary Disease Physician
Primary
A88835
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720148612
—
CA
01
—
8M5418
BCBS
TX
01
—
8V4803
BCBS
TX
05
—
GR050180
—
CA
01
—
ZZZ28595Z
BLUE CROSS/BLUE SHIELD
CA
Enumeration date
12/11/2006
Last updated
09/15/2008
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