COMMUNITY MEDICAL CENTERS INC (NPI# 1710542816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710542816 |
| Entity Type | Organization |
| Organization Name | COMMUNITY MEDICAL CENTERS INC |
| Other Organization Name | CMC, LODI VINE PEDIATRICS, SUITE 100 |
| Practice Address |
2415 W Vine St Ste 100 Lodi CA 95242-3731 |
| Mailing Address |
7210 Murray Dr Stockton CA 95210-3339 |
| Practice Telephone | 2093333135 |
| Mailing Telephone | 2093732800 |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2019-07-05 |
| Authorized Official Name | MRS. CHRISTINE NOGUERA (CEO) |
| Authorized Official Telephone | 2093732831 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| CMC, Lodi Vine Pediatrics, Suite 100 | Doing Business As Name - Organization |
| Community Medical Centers, Vine St., Ste. 100 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745928 | Community Medical Centers Inc | Clinic/Center | 747 E Channel St, Stockton, CA 95202-2628 | 2020-09-18 |
| 1891328803 | Community Medical Centers Inc | Clinic/Center | 1800 S Sutter St # 11b, Stockton, CA 95206-2004 | 2020-02-18 |
| 1043843428 | Community Medical Centers Inc | Pharmacy | 7912 West Lane, Ste. 221, Room 102, Stockton, CA 95210-3159 | 2020-02-13 |
| 1407460751 | Community Medical Centers Inc | Clinic/Center | 5151 Pacific Ave, Lock Center Room 126 & 128, Stockton, CA 95207-6304 | 2020-09-03 |
| 1164087268 | Community Medical Centers Inc | Clinic/Center | 2415 W Vine St Ste 105, Lodi, CA 95242-3731 | 2019-05-03 |
| 1205395712 | Community Medical Centers Inc | Clinic/Center | 1425 S Center St, Stockton, CA 95206-2016 | 2019-03-14 |
| 1205306628 | Community Medical Centers Inc | Clinic/Center | 2349 N California St, Stockton, CA 95204-5505 | 2018-11-28 |
| 1700373008 | Community Medical Centers Inc | Clinic/Center | 7912 West Ln Ste 221, Stockton, CA 95210-3159 | 2018-04-23 |
| 1164919049 | Community Medical Centers Inc | Clinic/Center | 2151 W Grant Line Rd, Tracy, CA 95377-7309 | 2018-04-17 |
| 1497261606 | Community Medical Centers Inc | Clinic/Center | 2135 N Tracy Blvd, Tracy, CA 95376-2424 | 2017-12-26 |
| Street Address |
2415 W VINE ST STE 100 |
| City | LODI |
| State | CA |
| Zip Code | 95242-3731 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386654077 | Lodi Memorial Hospital Association Inc | Clinic/Center | 2415 W Vine St Ste 100, Lodi, CA 95242-3731 | 2006-08-08 |
| 1952414013 | Terri Vaccarezza | Nurse Practitioner | 2415 W Vine St Ste 100, Lodi, CA 95242-3731 | 2006-08-15 |
| 1194738765 | Lisa Oneal | Nurse Practitioner | 2415 W Vine St Ste 100, Lodi, CA 95242-3731 | 2006-08-14 |
| 1598777120 | Laura Akahori | Nurse Practitioner | 2415 W Vine St Ste 100, Lodi, CA 95242-3731 | 2006-08-12 |
| 1689686263 | Christopher Doria | Pediatrics | 2415 W Vine St Ste 100, Lodi, CA 95242-3731 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285125807 | Victoria Galvez | Psychologist | 1103 Tudor St, Lodi, CA 95242 | 2018-05-21 |
| 1174931471 | Shuk Mei Chung | Physician Assistant | 2122 W Kettleman Ln, Lodi, CA 95242 | 2014-07-30 |
| 1275962169 | Sharon Elizabeth Palmer | Speech-Language Pathologist | 1200 W Tokay St, Lodi, CA 95242 | 2013-11-01 |
| 1114286093 | Brandee Lyn Smith | Speech-Language Pathologist | 1547 Lexington Dr, Lodi, CA 95242 | 2012-05-11 |
| 1255609509 | Jennifer Marie Wallmark | Speech-Language Pathologist | 8 S. Cambridge Dr., Lodi, CA 95242 | 2011-12-01 |
| 1649459546 | Kimberly Ann White | Counselor | 441 S. Ham Lane Suite A, Lodi, CA 95242 | 2007-10-26 |
| 1255541991 | Heather Baldauff | Occupational Therapist | 800 South Lower Sacramento Road, Lodi Memorial Hospital West, Lodi, CA 95242 | 2007-05-23 |
| 1730227182 | Clifford John Bradshaw | Dentist | 801 S Ham Lane, Suite D, Lodi, CA 95242 | 2007-02-01 |
| 1861541799 | Catherine Ann Gravish | Physical Therapist | 800 South Ham Lane, Lodi, CA 95242 | 2007-01-09 |
| 1497814511 | Stewart Chiropractic Corp | Chiropractor | 1420 W Kettleman Ln #k-1, Lodi, CA 95242 | 2006-12-06 |
| Find all providers in zip 95242 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659435279 | Community Medical Centers, Inc. | Clinic/Center | 721 Calaveras Street, Lodi, CA 95240-0628 | 2006-12-20 |
| 1164087268 | Community Medical Centers Inc | Clinic/Center | 2415 W Vine St Ste 105, Lodi, CA 95242-3731 | 2019-05-03 |
| 1801918743 | Community Medical Centers, Inc. | Clinic/Center | 2401 W Turner Rd, Suite 450, Lodi, CA 95242-2182 | 2007-04-04 |
| 1710009659 | Community Medical Centers, Inc. | Clinic/Center | 2401 W Turner Rd, Suite 450, Lodi, CA 95242-2182 | 2007-04-04 |
| 1881685964 | Community Medical Centers, Inc. | Clinic/Center | 2401 W Turner Rd, Lodi, CA 95242-2182 | 2005-10-28 |
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| 1235745928 | Community Medical Centers Inc | Clinic/Center | 747 E Channel St, Stockton, CA 95202-2628 | 2020-09-18 |
| 1760098503 | Chicago Clinica Medica Familiar Operated By Neighborhood Healthcare | Clinic/Center | 4022 Chicago Ave Ste A, Riverside, CA 92507-5340 | 2020-09-17 |
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| Find all providers with the same taxonomy | ||||
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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.