Organization
STOCKTON PATHOLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY MCDAVIT M.D. (AUTHORIZED OFFICIAL)
(209) 573-6555
Entity
Organization
Contact information
Practice address
1800 N CALIFORNIA ST, STOCKTON, CA 95204-6019
(209) 473-6555
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871522680
—
CA
01
—
ZZZ78143Z
CA MEDICARE
CA
Enumeration date
07/02/2006
Last updated
04/03/2024
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