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Organization

CALIFORNIA PRIMARY CARE MEDICAL GROUP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. OTASHE NYOKU GOLDEN M.D. (MEDICAL DIRECTOR)
(916) 837-1966
Entity
Organization

Contact information

Practice address
530 W ACACIA ST, STOCKTON, CA 95203-2454
(209) 944-5550
Mailing address
530 W ACACIA ST, STOCKTON, CA 95203-2454
(916) 944-5550

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
261QP2300X
Primary Care Clinic/Center
A70035
CA

Other

Enumeration date
05/21/2009
Last updated
05/21/2009
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