STOCKTON KIDNEY CLINIC, LLC (NPI# 1518166594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518166594 |
| Entity Type | Organization |
| Organization Name | STOCKTON KIDNEY CLINIC, LLC |
| Other Organization Name | STOCKTON KIDNEY CLINIC |
| Practice Address |
1523 E March Ln Stockton CA 95210 |
| Practice Telephone | 2094723300 |
| Practice Fax Number | 2094720900 |
| Mailing Telephone | 2094723300 |
| Mailing Fax Number | 2094720900 |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2007-07-11 |
| Authorized Official Name | JOSEPH MOYA (CORPORATE SECRETARY) |
| Authorized Official Telephone | 2094723300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
261QE0700X | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Stockton Kidney Clinic | Doing Business As Name - Organization |
| Street Address |
1523 E MARCH LN |
| City | STOCKTON |
| State | CA |
| Zip Code | 95210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790929826 | Roose Dialysis LLC | Clinic/Center | 1523 E March Ln, Ste 200, Stockton, CA 95210-5607 | 2009-04-20 |
| 1205081551 | Alejandro R Marquez | Dentist | 1523 E March Ln, Stockton, CA 95210-5607 | 2008-11-27 |
| 1427223544 | Community Dental Surgery Center | Clinic/Center | 1523 E March Ln, Suite 100, Stockton, CA 95310-5600 | 2008-04-29 |
| 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 | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437569514 | Coral Dialysis LLC | Clinic/Center | 1810 S Fresno Ave, Stockton, CA 95206-1861 | 2014-04-29 |
| 1104190826 | Satellite Dialysis of South Stockton LLC | Clinic/Center | 590 E Harding Wy, Stockton, CA 95204-6110 | 2012-02-27 |
| 1063586394 | Rai Care Centers of Northern California I, LLC | Clinic/Center | 3115 West March Lane, Stockton, CA 95219-2372 | 2006-11-20 |
| 1144260811 | Wellbound of Stockton LLC | Clinic/Center | 3555 Deer Park Dr, Suite 140, Stockton, CA 95219-2306 | 2006-06-08 |
| 1922069319 | Total Renal Care Inc | Clinic/Center | 7500 West Ln, Stockton, CA 95210-3312 | 2006-03-28 |
| 1437124476 | Dva Healthcare Renal Care Inc | Clinic/Center | 5608 N Pershing Ave, Stockton, CA 95207-4906 | 2006-02-22 |
| 1700203502 | Total Renal Care Inc | Clinic/Center | 7707 Austin Rd, Stockton, CA 95215-8312 | 2014-03-19 |
| 1790929826 | Roose Dialysis LLC | Clinic/Center | 1523 E March Ln, Ste 200, Stockton, CA 95210-5607 | 2009-04-20 |
| 1669546990 | Rai Care Centers of Northern California I, LLC | Clinic/Center | 2350 N California St, Stockton, CA 95204-5506 | 2006-11-20 |
| 1134142565 | Satellite Dialysis of Stockton LLC | Clinic/Center | 1801 E March Ln, Stockton, CA 95210-6629 | 2006-07-26 |
| Find all providers in STOCKTON | ||||
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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.