STOCKTON MEDICAL WEIGHT LOSS CENTER INC (NPI# 1770807901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770807901 |
| Entity Type | Organization |
| Organization Name | STOCKTON MEDICAL WEIGHT LOSS CENTER INC |
| Other Organization Name | PACIFIC MEDICAL WEIGHT LOSS |
| Practice Address |
1801 E. March Lane Suite 400d Stockton CA 95210 |
| Practice Telephone | 2092423334 |
| Mailing Telephone | 2092423334 |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2010-03-17 |
| Authorized Official Name | DR. DAREN STEPHEN PRIMACK (OWNER) |
| Authorized Official Telephone | 2092423334 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | STOCKTON MEDICAL WEIGHT LOSS CENTER INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RB0002X |
Internal Medicine Specialization: Obesity Medicine |
G68135 | CA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Pacific Medical Weight Loss | Doing Business As Name - Organization |
| Street Address |
1801 E. MARCH LANE SUITE 400D |
| City | STOCKTON |
| State | CA |
| Zip Code | 95210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750653929 | Divina Javier Fernandez | Registered Nurse | 1801 E. March Lane, Ste C320, Stockton, CA 95210-6676 | 2012-02-03 |
| 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 |
| 1699911412 | Pratap Krishna Anne | Pharmacist | 1801 E.march Ln, Suite:b280, Bjrx, Stockton, CA 95210 | 2008-12-29 |
| 1316116890 | Rami Georgies | Family Medicine | 8001 Lorraine Ave, Stockton, CA 95210 | 2008-02-28 |
| Find all providers in zip 95210 | ||||
| Taxonomy Code | 207RB0002X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Obesity Medicine |
| A physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the genetic, biologic, environmental, social, and behavioral factors that contribute to obesity. The obesity medicine physician employs therapeutic interventions including diet, physical activity, behavioral change, and pharmacotherapy. The obesity medicine physician utilizes a comprehensive approach, and may include additional resources such as dietitians, exercise physiologists, mental health professionals and bariatric surgeons as indicated to achieve optimal results. Additionally, the obesity medicine physician maintains competency in providing pre- peri- and post-surgical care of bariatric surgery patients, promotes the prevention of obesity, and advocates for those who suffer from obesity. |
| Notes: Source: American Board of Obesity Medicine, www.abom.org [7/1/2015: title and definition modified] Additional Resource: American Society of Bariatric Physicians, www.asbp.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619516531 | Jagraj Singh Basi | Internal Medicine | 2027 Grand Canal Blvd Ste 28, Stockton, CA 95207-6650 | 2019-12-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427517812 | Adventist Health Physicians Network | Internal Medicine | 951 E. Merritt Ave., Tulare, CA 93274 | 2019-03-15 |
| 1780030122 | Arthur Aronson | Internal Medicine | 450 A St Ste 400, San Diego, CA 92101-4217 | 2016-05-04 |
| 1962640508 | Ronnie Eugene Stone | Internal Medicine | 1835 Prairie City Rd, Suite #200, Folsom, CA 95630-9582 | 2009-02-04 |
| 1508057522 | Anthony Vu Huynh | Internal Medicine | 3100 Douglas Blvd Ste 204, Roseville, CA 95661-3868 | 2007-08-06 |
| 1598898462 | Prohealth Partners, A Medical Group, Inc. | Internal Medicine | 1760 Termino Ave Ste G18, Long Beach, CA 90804-2169 | 2007-03-13 |
| 1942258124 | Harpreet K Singh | Internal Medicine | 921 W 7th St, Oxnard, CA 93030-6755 | 2006-05-04 |
| 1134677446 | Professional Weight Control Centers | Internal Medicine | 4601 Telephone Rd, Suite 108, Ventura, CA 93003-5670 | 2016-09-15 |
| 1194172510 | 360 Medical Weight Specialists | Internal Medicine | 2255 Ygnacio Valley Rd, Suite G, Walnut Creek, CA 94598-3343 | 2016-05-16 |
| 1588033914 | Dietonix | Internal Medicine | 625 Citracado Pkwy, Suite 104, Escondido, CA 92025-6428 | 2015-09-16 |
| 1043656341 | Nancy P. Rahnama, M.d., A.p.c. | Internal Medicine | 421 N Rodeo Dr, Penthouse Number 1, Beverly Hills, CA 90210-4500 | 2013-05-14 |
| 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.