STOCKTON NEPHROLOGY, INC. (NPI# 1790110880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790110880 |
| Entity Type | Organization |
| Organization Name | STOCKTON NEPHROLOGY, INC. |
| Practice Address |
1525 N El Dorado St Suite 1 Stockton CA 95204-5932 |
| Practice Telephone | 2094655107 |
| Practice Fax Number | 2094657653 |
| Mailing Telephone | 2094655107 |
| Mailing Fax Number | 2094657653 |
| Enumeration Date | 2013-09-07 |
| Last Update Date | 2017-02-03 |
| Authorized Official Name | LAN NGOC QUANG (PRESIDENT) |
| Authorized Official Telephone | 4152835772 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
A111373 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
1525 N EL DORADO ST SUITE 1 |
| City | STOCKTON |
| State | CA |
| Zip Code | 95204-5932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437354347 | Lan Ngoc Quang | Internal Medicine | 1525 N El Dorado St, Suite 1, Stockton, CA 95204-5932 | 2007-06-19 |
| 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 | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497289789 | Mehul Raval | Internal Medicine | 1801 Each March Lane, Suite B265, Stockton, CA 95210-6655 | 2017-04-13 |
| 1710157474 | Mehul Raval | Internal Medicine | 1801 E March Ln Ste B265, Stockton, CA 95210-6655 | 2008-03-08 |
| 1841314853 | Nephrology Assoc Inc Me of The Bay Area | Internal Medicine | 7781 S Freedom Rd, San Joaquin Gen Hosp Dialysis Clinic, Stockton, CA 95231-3203 | 2007-03-16 |
| 1659307387 | Djamshid Moshirnia | Internal Medicine | 555 W Benjamin Holt Dr Ste 200a, Stockton, CA 95207-3839 | 2006-06-24 |
| 1083611594 | Randeep Singh Bajwa | Internal Medicine | 2350 N California St, Stockton, CA 95204-5506 | 2005-06-30 |
| 1972819803 | Pacific Kidney & Hypertension Inc | Internal Medicine | 2350 N California St, Stockton, CA 95204-5506 | 2010-08-30 |
| 1639317837 | Neha Nainani | Internal Medicine | 1801 E March Ln Ste B265, Suite B265, Stockton, CA 95210-6655 | 2009-01-26 |
| 1548449846 | Subrahmanyam Nasika | Internal Medicine | 1801 E March Ln, Suite B265, Stockton, CA 95210-6629 | 2007-11-02 |
| 1164544508 | Djamshid Moshirnia, M.d., Inc. | Internal Medicine | 555 W Benjamin Holt Dr Ste 200a, Stockton, CA 95207-3839 | 2007-04-05 |
| 1255485900 | Simar K. Dhaliwal | Internal Medicine | 7373 West Ln, Stockton, CA 95210-3377 | 2007-01-22 |
| 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.