DR. CHARLES ALLEN STILLMAN (NPI# 1508836453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508836453 |
| Entity Type | Individual |
| Full Name | DR. CHARLES ALLEN STILLMAN |
| Credential | D.O. |
| Practice Address |
546 E Pine St Stockton CA 95204-5525 |
| Mailing Address |
195 Gloria Cir Menlo Park CA 94025-3559 |
| Practice Telephone | 2094671000 |
| Practice Fax Number | 2094677335 |
| Mailing Telephone | 6504503150 |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2020-03-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
20A11027 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1508836453 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 801 S Ham Ln, Lodi, CA 952427501 | 2093661000 |
| Street Address |
546 E PINE ST |
| City | STOCKTON |
| State | CA |
| Zip Code | 95204-5525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568756096 | Valley Mri and Radiology Inc | Radiology | 546 E Pine St, Stockton, CA 95204-5525 | 2011-06-01 |
| 1659413664 | William Aubrey Federal | Radiology | 546 E Pine St, Stockton, CA 95204-5525 | 2007-02-13 |
| 1053341669 | Daniel Scott Dietrich | Radiology | 546 E Pine St, Stockton, CA 95204-5525 | 2006-07-03 |
| 1124054994 | Thurmond-federal Radiology and Imaging Medical Group, Inc. | Radiology | 546 E Pine St, Stockton, CA 95204-5525 | 2006-06-24 |
| 1598700171 | Valley Mri Center | Clinic/Center | 546 E Pine St, Stockton, CA 95204-5525 | 2006-06-18 |
| 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 | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366832313 | Quantum Medical Radiology of California, PC | Radiology | 10128 Tank House Dr, Stockton, CA 95209-4335 | 2015-01-29 |
| 1356538201 | Stockton Diagnostic Imaging | Radiology | 1801 E March Ln Ste A130, Stockton, CA 95210-6650 | 2007-09-25 |
| 1871584227 | David W H Wong | Radiology | 5832 Saint Andrews Dr, Stockton, CA 95219-1930 | 2005-11-03 |
| 1255721213 | Solano Diagnostics Partners, A California Limited Partnership | Radiology | 10128 Tank House Dr, Stockton, CA 95209-4335 | 2015-01-29 |
| 1578844973 | Rad Physicians Medical Corporation, Inc | Radiology | 1800 N California St, Stockton, CA 95204-6019 | 2011-08-30 |
| 1639499239 | Delta Radiology Medical Group Inc | Radiology | 10200 Trinity Pkwy, # 204, Stockton, CA 95219-7286 | 2010-06-04 |
| 1891936795 | Pavan Khanna | Radiology | 1800 N California St, Stockton, CA 95204-6019 | 2009-03-23 |
| 1730353137 | Delta Radiology Medical Group, Inc. | Radiology | 2320 N California St, Suite 3, Stockton, CA 95204-5509 | 2008-04-16 |
| 1013181411 | Delta Radiology Medical Group, Inc. | Radiology | 1617 N California St, Suite 1a, Stockton, CA 95204-6117 | 2008-04-16 |
| 1831317684 | Michael Shou Kobayashi | Radiology | 1801 E March Ln, Suite A130, Stockton, CA 95210-6629 | 2007-04-24 |
| Find all providers in STOCKTON | ||||
Please comment or provide details below to improve the information on DR. CHARLES ALLEN STILLMAN.
| 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.