CMC
Organization (NPI-2)
Active
Physician Assistant, Medical
Provider Information
- NPI Number
1699131110- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 1801 E MARCH LN STE D470, STOCKTON, CA, 952106677
- Phone
- (209) 507-7000
- Fax
- (209) 507-7550
Specialties & Taxonomies
Physician Assistant, Medical
Primary License: CA #PA22498