Organization
CENTER FOR SIGHT OF STOCKTON A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP A EDINGTON MD (DIRECTOR)
(209) 948-5515
Entity
Organization
Contact information
Practice address
1208 FLOYD AVE BLDG D, MODESTO, CA 95350-2470
(209) 622-2700
(209) 622-2710
Mailing address
1899 W. MARCH LANE, STOCKTON, CA 95207-6402
(209) 623-4700
(209) 623-4713
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ23858Z
GROUP PTAN
CA
Enumeration date
07/27/2006
Last updated
03/17/2018
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