LODI MEMORIAL HOSPITAL ASSOCIATION, INC (NPI# 1861649352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861649352 |
| Entity Type | Organization |
| Organization Name | LODI MEMORIAL HOSPITAL ASSOCIATION, INC |
| Other Organization Name | LODI MEMORIAL COMMUNITY CLINIC - IRIS |
| Practice Address |
801 S Ham Lane Suite S Lodi CA 95242-7501 |
| Mailing Address |
Po Box 3004 Lodi CA 95241-1908 |
| Practice Telephone | 2093343411 |
| Practice Fax Number | 2093397659 |
| Mailing Telephone | 2093343411 |
| Mailing Fax Number | 2093397659 |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2011-01-07 |
| Authorized Official Name | MR. JOSEPH P HARRINGTON (CHIEF EXECUTIVE OFFICER & PRESIDENT) |
| Authorized Official Telephone | 2093343411 |
| Is Organization Subpart | Y |
| Parent Organization Name | LODI MEMORIAL HOSPITAL ASSOCIATION, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
CA | Ambulatory Health Care Facilities | |
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
550000838 | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Lodi Memorial Community Clinic - Iris | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982860995 | Lodi Memorial Hospital Association, Inc | Clinic/Center | 10200 Trinity Parkway, Suite 102, Stockton, CA 95219-7249 | 2008-07-30 |
| 1225285695 | Lodi Memorial Hospital Association, Inc | Clinic/Center | 1235 W Vine St, Suite 22, Lodi, CA 95240-5109 | 2008-08-27 |
| Street Address |
801 S HAM LANE SUITE S |
| City | LODI |
| State | CA |
| Zip Code | 95242-7501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730227182 | Clifford John Bradshaw | Dentist | 801 S Ham Lane, Suite D, Lodi, CA 95242 | 2007-02-01 |
| 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 |
| 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 |
| 1144303389 | Richard S Forman Do Inc | Anesthesiology | 521 East Ham Lane, F, Lodi, CA 95242 | 2006-10-23 |
| Find all providers in zip 95242 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669743274 | Stockton Primary Care | Clinic/Center | 2068 Snowbird Dr, Lodi, CA 95242-4754 | 2012-01-13 |
| 1760620330 | Lodi Memorial Hospital Association, Inc. | Clinic/Center | 1901 W Kettleman Lane, Suite 200, Lodi, CA 95242-4337 | 2009-02-04 |
| 1023256880 | Lodi Memorial Hospital Association, Inc. | Clinic/Center | 2407 W Vine St, Suite A, Lodi, CA 95242-3730 | 2009-01-30 |
| 1306855523 | Lodi Memorial Hospital Association Inc | Clinic/Center | 2415 W Vine St Ste 105, Lodi, CA 95242-3731 | 2006-08-05 |
| 1225285695 | Lodi Memorial Hospital Association, Inc | Clinic/Center | 1235 W Vine St, Suite 22, Lodi, CA 95240-5109 | 2008-08-27 |
| 1235203688 | Lodi Children's Clinic Medical Corporation | Clinic/Center | 1920 Tienda Dr, Suite 102, Lodi, CA 95242-3930 | 2006-11-19 |
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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.