STOCKTON ENDOSCOPY CENTER LLC (NPI# 1386657666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1386657666 |
Entity Type | Organization |
Organization Name | STOCKTON ENDOSCOPY CENTER LLC |
Practice Address |
415 E Harding Way Suite E Stockton CA 95204 |
Mailing Address |
Po Box 39000 Dept 33691 09 San Francisco CA 94139 |
Practice Telephone | 2099421179 |
Practice Fax Number | 2099422200 |
Mailing Telephone | 6504937729 |
Mailing Fax Number | 6504937959 |
Enumeration Date | 2006-08-15 |
Last Update Date | 2020-08-22 |
Authorized Official Name | SAMUEL N MARCUS (CO FOUNDER) |
Authorized Official Telephone | 6504964141 |
Authorized Official Credential | MD PHD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
30000792 | CA | Ambulatory Health Care Facilities |
Street Address |
415 E HARDING WAY SUITE E |
City | STOCKTON |
State | CA |
Zip Code | 95204 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104827906 | Ronald C Allison | Specialist | 415 E Harding Way, #h, Stockton, CA 95204-6118 | 2005-08-03 |
1669755682 | Caroline D Andersen | Physician Assistant | 415 E Harding Way, Suite D, Stockton, CA 95204-6118 | 2011-09-26 |
1942589965 | Donna J Burke | Nurse Practitioner | 415 E Harding Way, Suite D, Stockton, CA 95204-6118 | 2011-08-08 |
1790080281 | Dr Thaker Md, A Professional Corporation | Obstetrics & Gynecology | 415 E Harding Way, Suite I, Stockton, CA 95204-6118 | 2011-01-14 |
1528362050 | Sutter Gould Medical Foundation | Clinic/Center | 415 E Harding Way, Suite E, Stockton, CA 95204-6118 | 2010-12-23 |
1700035334 | Masanobu Kamigaki | Internal Medicine | 415 E Harding Way, Suite D, Stockton, CA 95204-6118 | 2008-09-18 |
1659539153 | Ajay K Toppur Ramanakumar | Internal Medicine | 415 E Harding Way, Suite D, Stockton, CA 95204-6118 | 2008-05-30 |
1346276359 | Dean Karnaze | Specialist | 415 E Harding Way, Ste F, Stockton, CA 95204-6118 | 2006-06-23 |
1790720688 | Ronald Floyd Dugger | Specialist | 415 E Harding Way, Ste F, Stockton, CA 95204-6118 | 2006-06-17 |
1114969029 | John A Bouteller | Internal Medicine | 415 E Harding Way, Suite D, Stockton, CA 95204-6118 | 2006-06-12 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962027524 | Kariem Abdelwahed | Licensed Vocational Nurse | 1630 N. Edison St Stockton Ca, Stockton, CA 95204 | 2020-06-10 |
1831730555 | Ronnie C Murray | Counselor | 1947 North California Street, Stockton, CA 95204 | 2019-10-03 |
1235614116 | Michelle Ann Horn | Marriage & Family Therapist | 3666 Mission Rd, Stockton, CA 95204 | 2018-09-26 |
1356830947 | Stockton Pace | PACE Provider Organization | 582 E. Harding Way, Stockton, CA 95204 | 2018-05-09 |
1790228781 | Rebecca Phongsa | Counselor | 1947 North Calfornia Street, Suite B, Stockton, CA 95204 | 2016-11-23 |
1700332905 | Serim Kang | Driver | 4222 N Pershing Ave, Suite D2, Stockton, CA 95204 | 2016-08-28 |
1033565544 | Philip John Brereton | Orthotist | 466 E Harding Way, Stockton, CA 95204 | 2016-05-13 |
1932507522 | David Grayson | Counselor | 1621 Brookside Rd, Stockton, CA 95204 | 2014-12-12 |
1174934897 | Gurtej Malhi | Internal Medicine | 1901 N California Street, Stockton, CA 95204 | 2014-05-15 |
1396156170 | Rajesh Saini | Nurse Practitioner | 1805 N California St. Suite 102, Stockton, CA 95204 | 2014-05-14 |
Find all providers in zip 95204 |
Taxonomy Code | 261QA1903X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Ambulatory Surgical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922625995 | National Surgical Centers Stockton, LLC | Clinic/Center | 415 E Harding Way Ste E, Stockton, CA 95204-6118 | 2020-06-25 |
1316190796 | Sutter Gould Medical Foundation | Clinic/Center | 8011 Don Ave, Stockton, CA 95209 | 2008-10-29 |
1609041813 | Dental Surgery Centers of America | Clinic/Center | 1523 E March Ln Ste A, Stockton, CA 95210-5607 | 2008-04-29 |
1225138647 | American Dental Surgery Centers, Inc. | Clinic/Center | 1523 E. March Ln., Suite 100, Stockton, CA 95210-5663 | 2006-09-25 |
1730112178 | San Joaquin Laser and Surgery Center Inc | Clinic/Center | 1805 N California St Ste 101a, Stockton, CA 95204-6032 | 2006-07-09 |
1245285857 | Ambulatory Surgery Center of Eager Steven E Md Gen Ptr | Clinic/Center | 2388 N California St, Stockton, CA 95204-5506 | 2006-05-23 |
1619974219 | St. Joseph's Surgery Center Lp | Clinic/Center | 1800 N California St, Ste 1, Stockton, CA 95204-6019 | 2005-06-28 |
1417405234 | Psc Stockton Outpatient Surgery Center, LLC | Clinic/Center | 1805 N California St, Suite 405, Stockton, CA 95204-6037 | 2016-09-21 |
1467825844 | Sutter Valley Medical Foundation | Clinic/Center | 8011 Don Ave, Stockton, CA 95209-2841 | 2015-11-05 |
1598158487 | California Street Outpatient Surgery Center, LLC | Clinic/Center | 1805 N California St, Suite 405, Stockton, CA 95204-6037 | 2015-03-17 |
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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.