Individual
PETER G HICKOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
420 W ACACIA ST, SUTIE 11, STOCKTON, CA 95203-2441
(209) 948-4098
(209) 948-2334
Mailing address
420 W ACACIA ST, SUITE 11, STOCKTON, CA 95203-2441
(209) 948-4098
(209) 948-2334
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
G86782
CA
207V00000X
Obstetrics & Gynecology Physician
Primary
G86782
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G867820
—
CA
01
—
911803606
TAX ID
CA
Enumeration date
07/21/2005
Last updated
08/21/2013
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