DELTA HEART & MEDICAL CLINIC, INC. (NPI# 1013030006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013030006 |
| Entity Type | Organization |
| Organization Name | DELTA HEART & MEDICAL CLINIC, INC. |
| Practice Address |
1801 E March Ln A-170 Stockton CA 95210-6629 |
| Practice Telephone | 2099519884 |
| Practice Fax Number | 2099517873 |
| Mailing Telephone | 2099519884 |
| Mailing Fax Number | 2099517873 |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2008-10-29 |
| Authorized Official Name | BUNMI OLOWOYEYE (ADMINISTRATOR) |
| Authorized Official Telephone | 2099519884 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
A48005 | CA | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
A48005 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | HILL PHYSICIANS MED GROUP | 037196 | 01 |
| PTAN | OOA480050 | 01 | |
| CA | 00A480050 | 05 | |
| CA | BLUE SHIELD OF CA | ZZZ64420Z | 01 |
| RAILROAD MEDICARE PIN | DC3822 | 01 | |
| CA | 6923038 | 05 |
| Street Address |
1801 E MARCH LN A-170 |
| City | STOCKTON |
| State | CA |
| Zip Code | 95210-6629 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043215270 | Ronald A Kass | Internal Medicine | 1801 E March Ln, Suite C300, Stockton, CA 95210-6629 | 2005-06-15 |
| 1700327525 | Lakshmi Kulkarni | Pharmacist | 1801 E March Ln, Suite B280, Stockton, CA 95210-6629 | 2017-03-13 |
| 1811343734 | Josebelo D. Chong, M.d. Inc. | Internal Medicine | 1801 E March Ln, Suite C300, Stockton, CA 95210-6629 | 2016-05-10 |
| 1093113631 | Vijaysri Nannapaneni | Pharmacist | 1801 E March Ln, Suite B280, Stockton, CA 95210-6629 | 2014-12-15 |
| 1790107829 | Barry K Wilson Md Inc | Anesthesiology | 1801 E March Ln, Suite 360, Stockton, CA 95210-6629 | 2014-01-08 |
| 1396007100 | Jennifer Williams | Internal Medicine | 1801 E March Ln, Stockton, CA 95210 | 2012-06-08 |
| 1376815605 | Zeiter Eye Medical Group Inc Oculafacial Plastic and Reconstructive Su | Surgery | 1801 E March Ln, Suite A160, Stockton, CA 95210-6629 | 2012-02-02 |
| 1790080182 | James Lester Avery | Physician Assistant | 1801 E March Ln, D-460, Stockton, CA 95210-6629 | 2011-01-17 |
| 1477884161 | Kusum Lata | Internal Medicine | 1801 E March Ln, #a-170, Stockton, CA 95210-6629 | 2010-01-20 |
| 1023247079 | Valley Kidney Clinic Inc | Specialist | 1801 E March Ln, Suite B265, Stockton, CA 95210-6629 | 2009-07-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063021970 | Leslie Jazmin Marin | Student in an Organized Health Care Education/Training Program | 7109 Danny Dr, Stockton, Stockton, CA 95210 | 2020-07-27 |
| 1043866692 | Alexis Thomasson | Behavior Technician | 7109 Danny Drive, Stockton, CA 95210 | 2019-08-09 |
| 1821651324 | Maria Guadalupe Toledo | Lactation Consultant, Non-RN | 7912 Hammer Lane, Stockton, CA 95210 | 2019-04-19 |
| 1508226440 | Active Life Adult Day Care, Inc. | Clinic/Center | 7209 Tam O'shanter Dr., Stockton, CA 95210 | 2016-03-04 |
| 1548631260 | Rachel Standley | Substance Abuse Rehabilitation Facility | 8017 El Cajon St, Stockton, CA 95210 | 2015-10-08 |
| 1225435308 | Active Life Medical Produtcs Inc | Durable Medical Equipment & Medical Supplies | 611 W Grider Way, Stockton, CA 95210 | 2014-12-04 |
| 1942633318 | Kimberly Ruiz Dizon | Physician Assistant | 1530 E Hammer Ln, Stockton, CA 95210 | 2013-08-20 |
| 1285920983 | Supplemental Health Care | Preferred Provider Organization | 8425 Kiltie Wy, Stockton, CA 95210 | 2011-06-22 |
| 1770807901 | Stockton Medical Weight Loss Center Inc | Internal Medicine | 1801 E. March Lane, Suite 400d, Stockton, CA 95210 | 2010-03-17 |
| 1699911412 | Pratap Krishna Anne | Pharmacist | 1801 E.march Ln, Suite:b280, Bjrx, Stockton, CA 95210 | 2008-12-29 |
| Find all providers in zip 95210 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225380603 | Manshadi Heart Institute Inc | Internal Medicine | 2633 Pacific Ave, Stockton, CA 95204-4429 | 2012-10-09 |
| 1669544482 | Michael M. Zhu | Internal Medicine | 7373 West Ln, Stockton, CA 95210-3377 | 2006-11-15 |
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|---|---|---|---|---|
| 1104430412 | Anitha Rajamanickam Md Apmc | Internal Medicine | 3907 Waring Rd Ste 3, Oceanside, CA 92056-4454 | 2020-09-03 |
| 1316574890 | Woodland Hills Cardiology Group, PC | Internal Medicine | Woodland Hills Cardiology Group, PC, 22900 Ventura Blvd, Ste 165, Woodland Hills, CA 91364 | 2020-03-25 |
| 1841820677 | Sarsam Cardiology A Professional Corporation | Internal Medicine | 31285 Temecula Pkwy Ste 220, Temecula, CA 92592-6833 | 2020-01-21 |
| 1982246575 | Golden State Heart & Vascular Associates | Internal Medicine | 1850 El Camino Real Ste 200, Burlingame, CA 94010 | 2019-10-15 |
| 1861048613 | Sam Dawkins | Internal Medicine | Suite 415e, 8631 West Third Street, Los Angeles, CA 90048 | 2019-08-16 |
| 1336708494 | Peripheral Vascular Institute, Inc. A Podiatry Corp | Internal Medicine | 2100 Solar Dr Ste 103, Oxnard, CA 93036-0649 | 2019-06-11 |
| 1568020709 | Bakersfield Vascular Care Inc | Internal Medicine | 3550 Q St Ste 205, Bakersfield, CA 93301-1645 | 2019-06-03 |
| 1669974689 | Hossein Eftekhari Md Inc | Internal Medicine | 4147 Pascal Pl, Palos Verdes Peninsula, CA 90274-3941 | 2018-03-06 |
| 1104324102 | Adventist Health Physicians Network | Internal Medicine | 414 G St Ste 108, Marysville, CA 95901-5669 | 2018-01-25 |
| 1194223198 | Adventist Health Physicians Network | Internal Medicine | 414 G St Ste 210, Marysville, CA 95901-5669 | 2018-01-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.